Javed Nismat, Ashraf Shoaib, Gore Ankita, Aziz Mohammad, Aziz Muhammad Ali, Sklyar Eduard
Department of Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, Bronx, New York, USA.
Department of Cardiology, BronxCare Health System-Mount Sinai Morningside, Bronx, New York, USA.
Case Rep Cardiol. 2024 Nov 14;2024:5523100. doi: 10.1155/cric/5523100. eCollection 2024.
This case report discusses the diagnosis and management of a 25-year-old pregnant patient presenting with persistent tachycardia. The patient, with a past medical history of thyroiditis, polycystic ovarian syndrome, and obesity, was admitted due to palpitations and was diagnosed with atrial tachycardia. Despite medical management with metoprolol, adenosine, digoxin, and flecainide, the tachycardia persisted, necessitating discussion about cardiac ablation. The report emphasizes that atrial tachycardia poses a significant clinical challenge when refractory to medical therapy. It also highlights the condition's association with tachycardia-induced cardiomyopathy and the role of catheter ablation in its management. This case underscores the need for a high index of suspicion for atrial tachycardia in pregnant patients presenting with persistent tachycardia and the importance of appropriate referral for invasive management when medical therapy fails. The case also highlights that atrial tachycardia in pregnancy can be safely managed with ablation.
本病例报告讨论了一名25岁持续性心动过速的孕妇的诊断和治疗。该患者有甲状腺炎、多囊卵巢综合征和肥胖病史，因心悸入院，被诊断为房性心动过速。尽管使用美托洛尔、腺苷、地高辛和氟卡尼进行药物治疗，但心动过速仍持续存在，因此需要讨论心脏消融术。该报告强调，当药物治疗无效时，房性心动过速会带来重大的临床挑战。它还突出了该病症与心动过速性心肌病的关联以及导管消融术在其治疗中的作用。该病例强调了对持续性心动过速的孕妇高度怀疑房性心动过速的必要性，以及在药物治疗失败时进行侵入性治疗的适当转诊的重要性。该病例还突出表明，妊娠期间的房性心动过速可以通过消融术安全地进行治疗。
