Ventricular tachycardia with tension pneumothorax

Forester, Donald

doi:10.1016/s0361-1124(79)80381-0

Cited by 3 publications

(2 citation statements)

References 2 publications

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“…There are few reports of ST-segment elevations or ECG changes suggestive of acute MI [13,14], and these involved older patients with a tension pneumothorax and a previously known coronary heart disease. Only 1 case of ventricular tachycardia due to a pneumothorax has been reported [15].…”

Section: Discussionmentioning

confidence: 99%

Mechanical ventilation-associated pneumothorax presenting with paroxysmal supraventricular tachycardia in patients with acute respiratory failure

Eom

Lee

et al. 2015

Yeungnam Univ J Med

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The prevalence of pneumothorax cases among Intensive Care Unit patients who require mechanical ventilation ranges from 4%-15%. A pneumothorax remains one of the most serious complications of positive pressure ventilation. It can be diagnosed in a critically ill patient through a physical examination or radiographic studies that include chest radiographs, ultrasonography, or computed tomography scanning. However, in a critically ill patient, the diagnosis of a pneumothorax is often complicated by other diseases and by difficulties in imaging sick and unconscious patients. Although electrocardiogram changes associated with a pneumothorax have been described for many years, there has been no report of such among patients who require mechanical ventilation. In this paper, we report 2 cases of a spontaneous pneumothorax with paroxysmal supraventricular tachycardia in patients who required invasive mechanical ventilation due to acute respiratory failure.

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Section: Discussionmentioning

confidence: 99%

Mechanical ventilation-associated pneumothorax presenting with paroxysmal supraventricular tachycardia in patients with acute respiratory failure

Eom

Lee

et al. 2015

Yeungnam Univ J Med

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“…Other arrhythmias, however, appear to be rare and likely related to severe comorbidities. Ventricular tachycardia has been reported in association with tension pneumothorax [ 7 ] and also from chest tube insertion for the treatment of pneumothorax [ 8 ]. Genzwürker et al [ 9 ] reported a 25-year-old woman with polytrauma who underwent unsuccessful resuscitation for ventricular tachycardia and fibrillation; a chest tube, inserted due to suspected pneumothorax, was found to be dislocated in the subcutaneous tissue.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Tension Pneumothorax as a Cause of ICD Failure: A Case Report and Review of the Literature

Haq

Omar

2014

Case Reports in Cardiology

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Background. Tension pneumothorax can infrequently cause ventricular arrhythmias and increase the threshold of defibrillation. It should be suspected whenever there is difficulty in defibrillation for a ventricular arrhythmia. Purpose. To report a case of traumatic tension pneumothorax leading to ventricular tachycardia and causing defibrillator failure. Case. A 65-year-old African-American female was brought in to our emergency department complaining of dyspnea after being forced down by cops. She had history of mitral valve replacement for severe mitral regurgitation and biventricular implantable cardioverter defibrillator inserted for nonischemic cardiomyopathy. Shortly after arrival, she developed sustained ventricular tachycardia, causing repetitive unsuccessful ICD shocks. She was intubated and ventricular tachycardia resolved with amiodarone. Chest radiograph revealed large left sided tension pneumothorax which was promptly drained. The patient was treated for congestive heart failure; she was extubated on the third day of admission, and the chest tube was removed. Conclusion. Prompt recognition of tension pneumothorax is essential, by maintaining a high index of suspicion in patients with an increased defibrillation threshold causing ineffective defibrillations.

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Tension Pneumothorax: Etiology, Diagnosis, Pathophysiology, and Management

Gilbert

McGrath

1994

J Intensive Care Med

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Gilbert TB, XlcGrath BJ. Tension pneumothoras: etiology, diagnosis, pathophysiology, and management. J Intensive Care Ned 1994;93139-150.The normally air-free pleural cavity exists at subatmospheric pressure to promote pleural apposition and proper lung excursion. Owing to its unique bilayer structure, air introduced into this space either from within the thoracic cavity or from an extrathoracic source causes pleural separation and simple pneuniothorax (FTX). Most simple pneumothoracies of a small or static volume in healthy patients d o not appreciably impair cardiopulmonary function despite variable collapse of the lung. If increasing pressure develops within this pleural air collection, however, a cascade of pathophysiological changes can result from altered anatomical positions of heart, lung, and great vessels. The development of increasini pressure within the pleural space. with resultant ipsilateral lung collapse and hemithoracic expansion into the mediastinum and the contralateral lung, is termed tension pnenmothornu (TPTX). The exact incidence of TPTX is unknown, but it is reported in up to 2 to 3% of all pneumothoracies. Certain medical and surgical disease states-many found within the critical care environment-place patients at higher risk for development of TPTX and also limit physiological tolerance to TPTX once it occurs. Althoughphysical examinationand chest ndiography generally confirm the occurrence of TPTX, physiological monitoring may herald the development of increasing intrapleural pressure. Expeditious recognition and pleural decompression are necessary to prevent the untoward hemodynamic and respiratory consequences of TPTX. Significant morbidity and mortality may arise from TPTX if treatment is unduly delayed, particularly in mechanically ventilated patients.From the Each lung is wrapped by a closed invaginated sac-the pleura-a delicate bilayered serous membrane (Fig 1). Right and left sides in humans are completely separated by the bulk of the mediastinum. The pleura extends superiorly beyond the confines of the t h o r n into the base of the neck as the cupula. Inferiorly, it courses in tandem with the lung and diaphragm with an excursion between the two. On the right, it crosses the midzxillary line at the tenth rib, ending posterior to the spinous process of the twelfth rib. On the left, it courses slightly more inferiorly [I]. Thus, injury to the upper abdomen or neck can violate the pleura as well as injury throughout the entire thoracic cage. The portion of pleura that envelops the surface of the lung and invaginates the interlobar fissures is termed the u&-can1 pleim-a. The remaining membrane that lines the inner chest wall, the diaphragm, and the medial mediastinum is termed the parietalplera-a.A potential space containing a small amount of fluid exists between the contiguous pleural layers. Lung tissue acts as an interface between air-laden bronchoalveolar passages and the air-free pleural space, Intrapleural pressure varies from -3 to -5 mm Hg during inspiration and -5 to -10 mm...

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Ventricular tachycardia with tension pneumothorax

Cited by 3 publications

References 2 publications

Mechanical ventilation-associated pneumothorax presenting with paroxysmal supraventricular tachycardia in patients with acute respiratory failure

Mechanical ventilation-associated pneumothorax presenting with paroxysmal supraventricular tachycardia in patients with acute respiratory failure

Traumatic Tension Pneumothorax as a Cause of ICD Failure: A Case Report and Review of the Literature

Tension Pneumothorax: Etiology, Diagnosis, Pathophysiology, and Management

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