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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Prolonged ventricular pause associated with ticagrelor use: A case report.

Alaa Rahhal1, Amer Aljundi1, Sara Saeed Ibrahim Mohamed2

  • 1Pharmacy Department Heart Hospital Hamad Medical Corporation Doha Qatar.

Clinical Case Reports
|November 1, 2021
PubMed
Summary
This summary is machine-generated.

Ticagrelor may cause prolonged ventricular pauses in patients with myocardial infarction. Switching to clopidogrel resolved the issue, suggesting ticagrelor as the probable cause requiring close monitoring.

Keywords:
adverse drug reactionticagrelorventricular pause

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Non-ST elevation myocardial infarction (NSTEMI) management often involves antiplatelet therapy.
  • Ticagrelor is a P2Y12 inhibitor commonly used post-myocardial infarction.

Observation:

  • A 76-year-old female with NSTEMI experienced a significant 22-second ventricular pause.
  • This event occurred while the patient was treated with ticagrelor.

Findings:

  • The ventricular pause resolved after discontinuation of ticagrelor and initiation of clopidogrel.
  • The Naranjo algorithm indicated a probable association between ticagrelor and the prolonged ventricular pause.

Implications:

  • Ticagrelor use may be associated with adverse cardiac events like bradyarrhythmias.
  • Close cardiac monitoring is recommended during the initial phase of ticagrelor therapy, especially in elderly patients or those with cardiac history.