背景:多形性室性心动过速(PMVT)是一种不稳定且通常致命的快速心律失常。虽然这种节奏有很多原因,包括电解质失衡,缺血,和遗传性疾病,认识医源性病因很重要。阿比特龙是一种有效治疗前列腺癌的雄激素合成拮抗剂,但在这里,我们描述一例严重的低钾血症继发于阿比特龙,导致多形性室性心动过速和心脏骤停。虽然这是药物的潜在不利影响,严重的低钾血症导致多形性室性心动过速和心脏骤停,正如在我们的病人的情况下,没有被描述。
方法:一名有前列腺癌病史的78岁非洲裔美国男子表现为多形性室性心动过速和心脏骤停。复苏后,他被发现严重低血钾,难以大剂量补充。对低钾血症的次要原因的评估确定了可能的罪魁祸首是前列腺癌治疗的不良反应。
结论:多形性室性心动过速的广泛鉴别诊断对于识别和治疗出现这种心律的患者至关重要。在这里,我们介绍了一例继发于肿瘤治疗的医源性多形性室性心动过速。
BACKGROUND: Polymorphic ventricular tachycardia (PMVT) is an unstable and often fatal cardiac tachyarrhythmia. While there are many causes of this rhythm, including electrolyte imbalances, ischemia, and genetic disorders, iatrogenic etiologies are important to recognize. Abiraterone is an androgen synthesis antagonist effective in treating prostate cancer, but here we describe a
case of severe hypokalemia secondary to abiraterone resulting in polymorphic ventricular tachycardia and cardiac arrest. While this is a potential adverse effect of the medication, severe hypokalemia causing polymorphic ventricular tachycardia and cardiac arrest, as seen in our patient\'s
case, has not been described.
METHODS: A 78-year-old African-American man with history of prostate cancer presents with polymorphic ventricular tachycardia and cardiac arrest. After resuscitation, he was found to be severely hypokalemic and refractory to large doses of repletion. Evaluation of secondary causes of hypokalemia identified the likely culprit to be adverse effects from prostate cancer treatment.
CONCLUSIONS: A broad differential diagnosis for polymorphic ventricular tachycardia is essential in identifying and treating patients presenting in this rhythm. Here we present a
case of iatrogenic polymorphic ventricular tachycardia secondary to oncologic treatment.