"Esmolol" AND "Emergency"

Thyroid storm due to gestational trophoblastic disease (GTD) with metastatic choriocarcinoma is a rare but potentially life-threatening endocrine emergency. We report on a woman with molar pregnancy and metastatic choriocarcinoma who presented with thyroid storm (Burch-Wartofsky point scale of 45) a few weeks after the evacuation of GTD. She was initially managed with intravenous hydrocortisone, oral propylthiouracil (PTU), and esmolol infusion. After stabilization in the intensive care unit, 10 cycles of chemotherapy with etoposide, methotrexate, leucovorin, dactinomycin, and cyclophosphamide (EMA-CO) were initiated for stage 4 choriocarcinoma with brain and lung metastases...

Traumatic pulmonary artery pseudoaneurysms (PAP) are rare findings and are often associated with penetrating trauma to the chest. We present a case of a pulmonary artery pseudoaneurysm following blunt trauma. A 49-year-old man presented after a motor vehicle collision. Contrast enhanced computed tomography scans of the neck, chest, abdomen, and pelvis were obtained demonstrating a proximal right pulmonary artery pseudoaneurysm, small volume hemopericardium, left first rib fracture, and focal non-flow limiting dissection of left subclavian artery...

BACKGROUND: Nicardipine is commonly used in the management of hypertensive crises, except those involving cardiac contractility defects despite its ability to reduce afterload and pulmonary congestion. Consequently, there is limited literature evaluating nicardipine's role for this indication. The purpose of this study was to evaluate the efficacy and safety of nicardipine in adults with reduced ejection fractions presenting with acute heart failure with hypertension (AHF-H). METHODS: This was a retrospective study conducted at an academic Level 1 trauma center with an annual Emergency Department (ED) volume surpassing 100,000...

A boy in early childhood presented in cardiac arrest. Care was provided out of hospital and in the emergency department as per standard paediatric resuscitation guidelines. Despite initial return of spontaneous circulation following cardiopulmonary resuscitation, two defibrillation shocks and epinephrine via intraosseous access, he had recurrent episodes of pulseless ventricular tachycardia and ventricular fibrillation. In total, 40 defibrillation shocks were administered, and he subsequently stabilised on combined treatment with intravenous esmolol, amiodarone and milrinone...

OBJECTIVE: To review treatment options and updates that exist for the management of paroxysmal supraventricular tachycardia (PSVT). DATA SOURCES: A literature search of PubMed was performed including articles from 1974 to June 2023 using the terms: arrhythmias , adenosine , verapamil , diltiazem , esmolol , propranolol , metoprolol , beta-blockers , amiodarone , PSVT , synchronized cardioversion , methylxanthines , dipyridamole , pediatrics , heart transplant , and pregnancy ...

BACKGROUND: Sustained forms of tachycardia especially from the left ventricular summit are rare. Adenosine sensitive outflow tachycardias, especially from the left ventricular summit, are rarer still. These arrhythmias may be exercise or stress induced as they are facilitated by catecholamines and characteristically terminate with adenosine, vagal manoeuvres, and beta-blockers. The surface 12-lead electrocardiogram can be used to localize the anatomic site of origin before catheter ablation; however, prediction of the precise origin may still be challenging due to the intimate and complex anatomy of the outflow tracts...

Aneurysmal subarachnoid hemorrhage (SAH) is an acute neurologic emergency. We report the case of a 48-year-old male with a massive SAH caused by a ruptured aneurysm of the vertebrobasilar transition. During an urgent craniotomy, due to an aneurysm re-rupture, adenosine was given for flow arrest but no sinus pause was observed. Esmolol was administered and strategies for cerebral protection were implemented. The surgeon was able to clip the aneurysm and the patient was discharged after 78 days without sequelae...

[This retracts the article DOI: 10.1155/2022/9197369.].

OBJECTIVE: To investigate the value of maximal rate of left ventricular pressure (dp/dtmax) in evaluating the changes of cardiac function before and after heart rate reduction in patients with sepsis-induced cardiomyopathy (SIC). METHODS: A single-center, prospective randomized controlled study was conducted. Adult patients with sepsis/septic shock admitted to the department of intensive care unit (ICU) of Tianjin Third Central Hospital from April 1, 2020 to February 28, 2022 were enrolled...

IMPORTANCE: Preclinical and phase 1/2 studies with esmolol hydrochloride suggest its potential role in treatment of diabetic foot ulcers (DFUs). OBJECTIVE: To study the efficacy of topical esmolol for healing of uninfected DFUs. DESIGN, SETTING, AND PARTICIPANTS: A randomized, double-blind, multicenter, phase 3 clinical trial was conducted from December 26, 2018, to August 19, 2020, at 27 referral centers across India. Participants included adults with DFUs...

Hypertensive crisis and paroxysmal supraventricular tachycardia are serious adverse reactions that can lead to fatal consequences. We reported a 28-year-old woman who underwent emergency cesarean section of her first fetus due to pelvic outlet stenosis and had a hypertensive crisis, merging with paroxysmal supraventricular tachycardia after dezocine was administrated during the procedure. Her symptoms returned to normal after esmolol and urapidil were administrated. In order to rule out hypertension crisis caused by other diseases, the anesthesiologist immediately accessed the thyroid function, myocardial enzymes, catecholamines, and arterial blood gas analysis of the patient...

Thyroid storm is a challenging medical emergency that requires urgent assessment and management in a timely manner. In this article, we report on a case of a 37-year-old female who presented to the emergency department with a thyroid storm complicated by atrial fibrillation (AF) with a rapid ventricular response with no clinical signs of heart failure. As part of her medical management to rate control her AF, she was started on an infusion of a short-acting beta blocker, esmolol, and shortly after, she developed cardiac arrest...

Atrial fibrillation is a common manifestation seen in patients with hyperthyroidism and thyroid storm. The presence of excess thyroid hormone (TH) alters adrenergic receptors in the heart and blood vessels, thereby causing an increase in sympathetic function and atrial fibrillation as a sequela of this excess circulating hormone. Excess thyroid hormone (T3) shortens the action potential of cardiomyocytes in the pulmonary vein, which facilitates the generation of reentrant circuits causing atrial fibrillation...

BACKGROUND: TANGO2-related metabolic encephalopathy and arrhythmia are a rare, newly recognized, and likely under-diagnosed condition. First described in 2016, it is characterized by developmental delay and recurrent metabolic crisis. During these episodes, patients may present QTc prolongation and ventricular arrhythmias. CASE SUMMARY: A 13-year-old female, with developmental delay, presented with severe rhabdomyolysis and an initially normal electrocardiogram (ECG)...

Caffeine (1,3,7-trimethylxantine), a structural analog of adenosine, is widely used as a central nervous system stimulant in beverages and drugs. Caffeine overdose induces hypokalemia, fatal ventricular fibrillation, and cardiac arrest, resulting in death. We describe a case of caffeine overdose that presented with refractory ventricular fibrillation that was treated with supportive care because invasive care for severely ill patients was limited due to the COVID-19 pandemic. A 20-year-old woman with no underlying medical history ingested 90,200-mg caffeine tablets (total dose 18 g) in a suicide attempt...

BACKGROUND: Electrical storm (ES) is a heterogeneous clinical emergency that can present with malignant ventricular arrhythmias such as ventricular fibrillation (VF), ventricular tachycardia (VT), requiring the need for cardiac defibrillation. ES is a life-threatening condition with a high mortality rate. Successfully managing ES in the setting of acute myocardial infarction (MI) is expected to be known by physicians on call to reduce in-hospital mortality. CASE PRESENTATION: A 57-year-old man presenting with acute onset chest pain was found to have an infero-posterior ST-segment elevation myocardial infarction (STEMI) complicated by acute right ventricular MI secondary to total occlusion of the proximal right coronary artery (RCA)...

BACKGROUND: Refractory ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) cardiac arrest describes a subset of patients who do not respond to standard Advanced Cardiac Life Support (ACLS) interventions and are associated with poor outcomes. Esmolol administration and vector change defibrillation have shown promise in improving outcomes in these patients, however evidence is limited. OBJECTIVES: This study compares clinical outcomes between patients with prehospital refractory VF/pVT who received an Emergency Medical Service (EMS) bundle, comprised of esmolol administration, vector change defibrillation, and dose-capped epinephrine at 3 mg, to patients who received standard ACLS interventions...

UNLABELLED: Suicide left ventricle (SLV) is a well-documented complication after surgical or transcatheter aortic valve replacement. We present an unusual case of a patient who developed left ventricular outflow tract (LVOT) obstruction with a native aortic valve, resulting in SLV after routine non-cardiac surgery. A 45-year-old male presented to the emergency room with abdominal pain and was diagnosed with acute cholecystitis. The patient had a known medical history of severe left ventricular hypertrophy...

Objective: To probe into the effects of amiodarone and esmolol for heart rate disorders and myocardial infarction. Methods: 76 cases of cardiopathy in our hospital from July 2019 to October 2021 were analyzed for myocardial infarction. The control group applied amiodarone treatment. Blood pressure, treatment effect, adverse reactions, myocardial marker levels, electrocardiogram, and heart function indicators were compared. Results: There were no statistical differences in two groups of diastolic pressure ( P > 0...

Background: Esmolol may increase survival for patients with refractory ventricular fibrillation (RVF); however, information related to esmolol use in the prehospital environment is limited. We aimed to assess the feasibility of prehospital bolus dose esmolol for patients with RVF treated by a high-volume, ground-based emergency medical services (EMS) agency. Methods:  Esmolol (0.5 mg/kg single bolus) was added to the RVF protocol on December 10, 2018. Feasibility was defined as esmolol administration in >75% of RVF cases...