Case 154

Abstract

A 55-year-old man with a history of an inferior myocardial infarction treated with primary angioplasty with stenting 4 h after the onset of pain presented to an outside hospital with lightheadness. His blood pressure was 90/60 and his heart rate was 190 bpm. His ECG revealed a wide complex tachycardia (Fig. 154.1). He was cardioverted and started on amiodarone. His echocardiogram the next morning revealed an EF of 45% with an inferior wall motion abnormality. Coronary angiography showed a patent right coronary stent and no disease in the left coronary system. Despite oral loading with 10 g of amiodarone over the next several days he continue to have symptomatic runs of the same wide complex tachycardia. © Springer-Verlag London Limited 2011.