Dental management of a patient with catecholaminergic polymorphic ventricular tachycardia: a case report

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a type of cardiac arrhythmia that occurs in people with a structurally normal heart. Stress or anxiety-induced release of endogenous catecholamines causes a dysfunction in the myocytic calcium-ion channel, leading to ventricular arrhythmias that can cause dizziness, syncope, or sudden cardiac death. Since dental procedures can be anxiety-provoking, the main purpose of this paper is to report the dental management of a young patient with dental fear and CPVT. Several other issues are also discussed, such as the importance of continual collaboration with medical colleagues, the risk-benefit of using epinephrine-containing local anesthesia for dental treatment for patients with arrythmias, the potential risk of repeated general anesthesia in a patient with a cardiac arrhythmia, and the challenges of providing comprehensive dental treatment in a high caries-risk patient with extreme dental anxiety.