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Abstract: Ventricular prophase contractions are among the most common types of arrhythmias, occurring mostly before a normal heartbeat. A 49-year-old male patient with sudden onset of palpitations 7 days ago and again 3 days ago with more intense palpitations came to our hospital and was diagnosed with this disease by electrocardiography.
Basic information】Male, 49 years old
Disease Type】Cardiac arrhythmia (ventricular asystole)
Hospital】Senior Hospital of Central South University
Time of consultation】January 2022
Treatment plan】Intravenous infusion (adenosine triphosphate disodium injection, Xiangdan injection) + oral medication (ginseng heart capsule, metoprolol tartrate tablets, Yixinshu tablets, Eprazole enteric coated tablets)
[Treatment period] 3 days of hospitalization, long-term follow-up
Treatment effect] The palpitations disappeared and the condition was stable.
I. Initial consultation
The patient is a 49-year-old male. 7 days ago, he had palpitations without any obvious cause, which lasted 15-30 minutes each time and were not violent, with a heart rate of 150-170 beats/min. Three days ago, the palpitations reoccurred and were more intense than before, so he went to our hospital. On examination, there was no enlargement of the heart borders, the heart rate was 67 beats/min, the heart rhythm was uniform, and there was no pathological murmur. The electrocardiogram showed sinus bradycardia, high voltage in the right ventricle, and flat T waves in some leads; the cardiac ultrasound showed no significant abnormalities. The initial diagnosis was ventricular asystole, and the patient was admitted to the hospital for treatment.
II. Treatment history
After the patient was admitted to the hospital, the relevant tests were completed, and the ambulatory ECG showed abnormalities, which were combined with the ECG and clinical symptoms to clarify the diagnosis of ventricular asystole. After communication with the patient, he was given a treatment plan to improve myocardial blood supply and myocardial metabolism and to maintain a stable internal environment, and blood pressure and heart rate were monitored. Intravenous drip adenosine triphosphate disodium injection can improve myocardial metabolism, and the use of shantan injection can dilate blood vessels and improve myocardial blood supply. At the same time, oral ginseng heart capsule, metoprolol tartrate tablets and Yixinshu tablets are used to dilate blood vessels and improve myocardial blood supply, and eprazole enteric tablets are used to inhibit gastric acid and protect gastric mucosa.
III. Treatment effect
Three days after admission, the patient complained of improved palpitations, sleep quality at night, no profuse sweating, and no symptoms of chest tightness and chest pain. The patient’s heart rate was 60 beats/min, rhythmical, no pathological murmur, and the general condition was good, so he could be discharged after comprehensive consideration, and continued to take medication at home. 1 month later, the patient returned to the hospital for review, and reported no obvious palpitation symptoms.
IV. Notes
I was glad to see that the patient was happily discharged from the hospital. And advised the following precautions after going home.
1.After going home, pay attention to rest, avoid getting cold, strain and infection, and try to avoid catching a cold.
2. Take medication regularly after going home and avoid stopping or reducing medication on your own. If there is nausea or vomiting after taking medication, go to our department in time so that the medication can be adjusted.
3, the diet should be light, pay attention to low salt, low fat, avoid overeating, so as not to be detrimental to the control of the disease.
4. Regularly review the liver and kidney functions, electrolytes and ECG, and monitor blood pressure and heart rate by yourself.
V. Personal insight
Palpitations may be physiological, functional and pathological causes, for physiological and functional palpitations do not require special treatment. However, for pathological palpitations, especially those caused by arrhythmias, prompt hospital consultation should be sought. The patient in this case went to the hospital promptly after the sudden onset of palpitations, but was not treated at the first visit and was treated regularly only after another attack. After discharge from the hospital, he also took his medication regularly and his condition was better controlled.