Casos

Severe Left Ventricular Heart Failure in Young Woman with Sustained Broad Complex Tachycardia

Dr. Priscilla Marques
Dr. Priscilla Marques
Brazil

Case presentation

  • L. M. S., 18 years old, female Date: Feb 2, 2014
  • Complaint: “tiredness”.
  • Current affection history: Patient admitted in the hospital due to dyspnea starting 3 days ago, associated to diaphoresis, cold and poorly perfused limbs.
  • Previous pathological history: She denies having sHTN, DM2. Heart disease of indefinite etiology diagnosed around 1 year ago, during the 4th month of pregnancy, with dyspnea and pulmonary congestion. After decompensation, the patient evolved with an early delivery followed the fetal death.
  • Social pathological history: She denies smoking or drinking alcohol.
  • Family history: no history of CVD or SCD.

Physical examination at admission

  • Regular general condition, pale, +/4+, no fever, cold limbs.
  • BP: 85×56 mmHg HR: 89 bpm SatO2: 86%
  • Respiratory system: gross vesicular murmur, with rough sounds and diffuse crepitations.
  • Cardiovascular system: irregular heart rhythm, muffled noises without murmurs.
  • Lower limbs: no edema, free calves, slow perfusion.

Apresentaçao do caso

  • L. M. S., 18 anos, sexo feminino DIH: 09/02/14
  • QP: “Cansaço”.
  • HDA: Paciente admitida no HM com quadro de dispnéia iniciado há 3 dias

    da admissão, associado a diaforese, extremidades frias e mal perfundidas.

  • HPP: Nega HAS, DM2. Cardiopatia de etiologia indefinida diagnosticada há +- 1 ano, durante 4o mês gestacional, com quadro de dispnéia e congestão pulmonar Após descompensação, paciente evoluiu com parto prematuro seguido por óbito fetal.
  • HP Social: Nega tabagismo e etilismo.
  • H familiar: sem relato de DCV ou MS.

Exame 5ísico da admissão

• REG, hipocorada +/4+, afebril, extremidades frias. • PA: 85×56 mmHg FC: 89bpm SatO2: 86%
• AR: MV rude , com roncos e crepitações difusas.
• ACV: RCI Bulhas hipofonéticas sem sopros.

• MMII: sem edemas, panturrilhas livres, perfusão lentificada.

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Auspicios Institucionales
  • Sociedad Argentina de Cardiología
  • Federación Argentina de Cardiología
  • SIAC
  • SADEC
  • Asociación Argentina de Cardiología
  • Latin American Heart Rhythm Society
  • Fundación Barceló - Facultad de Medicina