Tachycardia cardiopulmonary arrest

The most frequent symptoms of anaphylaxis in patients with mastocytosis are decreased blood pressure and tachycardia. Also observed are dizziness, dyspnea, flushing, nausea and diarrhea [4]. Severe reactions are typical for patients with mastocytosis. In 55 patients with insect sting allergy and confirmed mastocytosis, 81% of patients experienced severe anaphylaxis with shock or cardiopulmonary arrest, whereas clinical reactions of this severity occurred in only 17% of 504 patients without evidence for mastocytosis and normal tryptase levels [29]. In another study in... 

Cardiopulmonary arrest in adults usually results from arrhythmias. The most common arrhythmias are ventricular fibrillation (VF) and pulseless ventricular tachycardia (PVT), often in patients after myocardial infarction (MI) or pulmonary embolism (PE). In children, cardiopulmonary arrest is often the terminal event of progressive shock or respiratory failure. 

FIGURE 7-1. Advanced cardiac life support (ACLS) treatment algorithm for adult cardiopulmonary arrest. (CPR, cardiopulmonary resuscitation PEA, pulseless electrical activity PVT, pulseless ventricular tachycardia VF, ventricular fibrillation.)... 

Cardiovascular Effects. One of the patients described by Letz et al. (1984) (see Section 2.2.3.1) who had a terminal cardiopulmonary arrest had acute myocardial interstitial edema, myocardial inflammation, and Gram-positive sporulating rods at necropsy. The second patient initially had a normal electrocardiogram, but as his renal and hepatic function deteriorated, eventually developed supraventricular tachycardia and asystole. 

A 43-year-old man injected a large dose of cocaine in a suicide attempt and had a seizure and cardiopulmonary arrest, from which he was resuscitated. His arterial blood pH was 6.72 and his electrocardiogram showed a wide complex tachycardia. An infusion of sodium bicarbonate maintained the blood pH at 7.50 and the electrocardiogram became normal. The bicarbonate infusion was discontinued after 12 hours. 

Cardiac dysrhjdhmias have been reported after amsacrine therapy in association with hypokalemia. Pre-existing supraventricular dysrhjdhmias or ventricular extra beats are not absolute contraindications to its use (49). Of 5430 patients treated with amsacrine, 65 developed cardiotoxicity, including prolongation of the QT interval, non-specific ST-T wave changes, ventricular tachycardia, and ventricular fibrillation (50). There were serious ventricular dysrhythmias resulting in cardiopulmonary arrest in 31 patients 14 died as a result. The dysrhjdhmias occurred within minutes to several hours after drug administration. The cardiotoxicity was not related to total cumulative dose, and hypokalemia was possibly a risk factor for dysrhythmias. 

Adverse reactions Respiratory depression, apnea, shock and cardiopulmonary arrest sedation, dizziness, hallucinations, disorientation, agitation, euphoria, dysphoria insomnia headache miosis, tachycardia, palpitations, chest wall rigidity, syncope and edema nausea, vomiting and constipation dry mouth anorexia and spasms of the colon urinary retention or hesitancy decreased libido rash, flushing physical ana psychological dependence can occur... 

Drug overdose Life-threatening flecainide intoxication in a 2-year-old toddler occurred when syringes used for oral administration were accidentally reversed, producing a fivefold flecainide overdose 3 hours after drug administration he developed a bradycardia of 50/minute and had a cardiopulmonary arrest, requiring resuscitation and adrenaline, after which the bradycardia recurred, followed by a wide-complex tachycardia that converted rapidly to a narrow-complex tachycardia after bolus intravenous adrninistration of sodium bicarbonate [60 ]. He then remained hemo-dynamicaUy stable and in sinus rhjflhm. The serum flecainide concentration was 0.7 mg/1. 

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