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1 Authorship: Co-first authors/equal contributions. All authors had access to the data and a role in writing this manuscript. NZ: Conceptualization, Writing - original draft; JL: Conceptualization, Writing - review & editing; TL: Supervision, Funding acquisition; BC: Supervision.
Nan Zhang
Footnotes
1 Authorship: Co-first authors/equal contributions. All authors had access to the data and a role in writing this manuscript. NZ: Conceptualization, Writing - original draft; JL: Conceptualization, Writing - review & editing; TL: Supervision, Funding acquisition; BC: Supervision.
Affiliations
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
1 Authorship: Co-first authors/equal contributions. All authors had access to the data and a role in writing this manuscript. NZ: Conceptualization, Writing - original draft; JL: Conceptualization, Writing - review & editing; TL: Supervision, Funding acquisition; BC: Supervision.
Jian Liu
Footnotes
1 Authorship: Co-first authors/equal contributions. All authors had access to the data and a role in writing this manuscript. NZ: Conceptualization, Writing - original draft; JL: Conceptualization, Writing - review & editing; TL: Supervision, Funding acquisition; BC: Supervision.
Affiliations
Intensive Care Unit, Second Hospital of Tianjin Medical University, Tianjin, China
Requests for reprints should be addressed to Tong Liu, MD, PhD, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, No. 23, Pingjiang Road, Hexi District, Tianjin 300211, People’s Republic of China.
Affiliations
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
Requests for reprints should be addressed to Bing Chen, MD, Intensive Care Unit, Second Hospital of Tianjin Medical University, No. 23, Pingjiang Road, Hexi District, Tianjin 300211, People’s Republic of China.
1 Authorship: Co-first authors/equal contributions. All authors had access to the data and a role in writing this manuscript. NZ: Conceptualization, Writing - original draft; JL: Conceptualization, Writing - review & editing; TL: Supervision, Funding acquisition; BC: Supervision.
A 17-year-old young woman presented to the Emergency Department with a 1-hour history
of abdominal pain, nausea, vomiting, and weakness. Physical examination on admission
revealed a heart rate of 106 beats per minute, blood pressure of 136/88 mm Hg, and
a respiratory rate of 25 breaths per minute. Her medical history was unremarkable
with no prior medical comorbidities or surgical history. She denied taking any prescribed
or over-the-counter medications. The initial electrocardiogram (ECG) showed ventricular
tachycardia (VT) (Figure 1), with investigations revealing a normal troponin I level of <0.03 ng/mL (reference
range <0.3 ng/mL), elevated N-terminal pro-brain natriuretic peptide level of 439.2
ng/L (reference range <300 ng/L), and normal serum potassium level of 4.0 mmol/L (reference
range 3.5-5.3 mmol/L). Over the next hours, the patient developed shallow respirations,
with rapid worsening of muscle weakness involving all 4 limbs. An arterial blood gas
obtained on room air revealed severe acidosis (pH, 7.178) and hypoxemia (PaO2, 65.8 mm Hg). A repeated blood test conducted 4 hours after admission noted profound
hypokalemia (serum potassium, 1.9 mmol/L).
Figure 1Electrocardiogram (ECG) at admission. The admission ECG revealed a wide complex tachycardia
at a rate of 106 beats per minute, a QRS duration of 200 ms, an initial dominant R
wave in aVR, a fusion complex in the 7th beat, northwest axis deviation, positive
monophasic QRS complexes in V1, and an R/S ratio <1 in V6, which suggested a diagnosis
of ventricular tachycardia, probably originating from the free wall of the left ventricle.
