Bidirectional Ventricular Tachycardia with Stress-Induced Cardiomyopathy.

Area of Science:

• Cardiology
• Electrophysiology
• Toxicology

Background:

• Bidirectional ventricular tachycardia (BDVT) is a rare wide-complex tachycardia with alternating QRS morphology.
• Proposed mechanisms include triggered activity or enhanced automaticity due to calcium dysregulation.
• Catecholamine surges can induce myocardial injury and calcium dysregulation, predisposing to arrhythmias like BDVT.

Observation:

• This case report details a unique presentation of BDVT.
• The patient experienced a significant catecholamine surge following multiple traumatic gunshot wounds.
• Methamphetamine use was a contributing factor in the clinical scenario.

Findings:

• The patient presented with bidirectional ventricular tachycardia.
• The arrhythmia was associated with stress-induced cardiomyopathy.
• The underlying cause was attributed to a catecholamine surge exacerbated by methamphetamine use.

Implications:

• This case underscores the potential for severe cardiac arrhythmias in trauma patients with substance use.
• It highlights the critical role of catecholamine surges in precipitating life-threatening arrhythmias.
• Understanding these associations is crucial for managing complex trauma and toxicology cases.