Ventricular tachycardia clinical presentation

Amiodarone may elicit life-threatening side effects in addition to presenting substantial management difh-culties associated with its use. The oral formulation of amiodarone is indicated only for the treatment of life-threatening recurrent ventricular arrhythmias (e.g., recurrent ventricular hbrillation and/or recurrent hemo-dynamicaUy unstable ventricular tachycardia) that have not responded to other potentially effective antiarrhythmic drugs or when alternative interventions could not be tolerated. Despite its efficacy as an antiarrhythmic agent, there is no evidence from clinical trials that the use of amiodarone favorably affects survival. 

Other less frequent complications of lead extraction include arteriovenous fistulas that present either acutely or in the days following the procedure. Pericardial tamponade could be clinically evident several hours after the procedure. Patients undergoing lead extraction should be monitored for at least 24 h in the intensive care unit, with echocardiography performed electively immediately after the procedure and 6 h later to evaluate the pericardial space and tricuspid valve integrity. Life-threatening arrhythmias such as ventricular tachycardia, torsade de pointes, and ventricular fibrillation are rare but possible complications. 

Overdose is common amongst users (up to 22% of heavy users report losing consciousness). The desired euphoria and excitement turns to acute fear, with psychotic symptoms, convulsions, hypertension, haemorrhagic storke, tachycardia, arrhythmias, hyperthermia coronary vasospasm (sufficient to present as the acute coronary syndrome with chest pain and myocardial infarction) may occur, and acute left ventricular dysfunction. Treatment is chosen according to the clinical picture (and the known mode of action), from amongst, e.g. haloperidol (rather than chlorpromazine) for mental disturbance diazepam for convulsions a vasodilator, e.g. a calcium channel blocker, for hypertension glyceryl trinitrate for myocardial ischaemia (but not a p-... 

Cardiovascular Essential hypertension and electrocardiographic changes are present (ST-segment depression or flattening, T-wave inversion, and U-wave elevation). Clinical arrhythmias include heart block, atrial flutter, paroxysmal atrial tachycardia, ventricular fibrillation, and digitalis-induced arrhythmias. 

---