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High Dose Neostigmine Treatment of Malignant Sinus Tachycardia
Author(s) -
SCHULTHEIS LEX W.,
BALSER JEFFREY R.,
CALKINS HUGH,
ROBERTSON SHAWN,
WEISS JAMES L.,
SUSSMAN MARC,
STUART R. SCOTT
Publication year - 1997
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1997.tb06795.x
Subject(s) - medicine , cardiology , tachycardia , sinus tachycardia , heart rate , cardiogenic shock , anesthesia , heart failure , blood pressure , shock (circulatory) , stroke volume , myocardial infarction
We report the case of a patient with Wolff‐Parkinson‐White syndrome with angina and cardiogenic shock who improved dramatically following administration of neostigmine. Cardiac output, blood pressure, and stroke volume increased as heart rate was reduced. A previous attempt at heart rate control, in the same patient, using a low dose β antagonist, precipitated hemodynamic collapse. The remarkable recovery of our patient suggests that acetylcholinesterase inhibitors may warrant further investigation in patients with severe sinus tachycardia.