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Prolonged QT syndrome: perioperative management
R A Strickland1, M S Stanton, K D Olsen
1Department of Anesthesiology, Mayo Clinic Rochester, MN 55905.
Mayo Clinic Proceedings
|October 1, 1993
Summary
Intraoperative cardiac arrhythmias are rare in patients with prolonged QT syndrome. This case highlights a ventricular fibrillation event during head and neck surgery, emphasizing careful perioperative management.
Area of Science:
- Cardiology
- Anesthesiology
- Otolaryngology
Background:
- Prolonged QT syndrome (LQTS) is a rare cardiac channelopathy associated with life-threatening arrhythmias.
- Intraoperative arrhythmias in LQTS patients are uncommon but pose significant anesthetic challenges.
Observation:
- A 26-year-old woman with known LQTS developed ventricular fibrillation during a partial glossectomy and neck dissection.
- The surgical procedure involved head and neck manipulation, potentially impacting autonomic tone.
Findings:
- The specific surgical procedure may have contributed to the intraoperative ventricular fibrillation in this LQTS patient.
- Prompt recognition and management of the arrhythmia were crucial for patient survival.
Implications:
- This case underscores the importance of vigilant perioperative monitoring for patients with LQTS undergoing surgery.
- Reviewing perioperative management strategies for LQTS patients is essential to prevent and manage intraoperative cardiac events.
- Anesthetic management should consider potential triggers for arrhythmias in LQTS patients during head and neck procedures.