Pronounced unexplained preoperative tachycardia heralding serious cardiac events: a series of three cases

Unexplained preoperative tachycardia: is it an important issue?

“…In the third case tachycardia led to crushing substernal pain (first episode ever). 1 Cardiac investigations revealed mitral valve prolapse with mild regurgitation. Palpitations are a common feature of this condition; paroxysmal re-entry supraventricular tachycardia is also observed.…”

“…Narrow complex tachycardia occurred in the second patient (case 2). 1 After medication it evolved into wide-complex tachycardia with hypotension. Postoperatively, extensive cardiac evaluation did not reveal any abnormalities.…”

“…20 Even in the absence of underlying cardiac disorder, ß-blockade can prevent the recurrence of narrow complex tachycardia (case 2). 1 Because of the almost infinite variety of causes of tachycardia, it is impossible to define a single value for heart rate above which surgery should always be deferred. What is important, however, is to be aware of the numerous pathologies that can underlie preoperative tachycardia and to try to identify them, as both the cause of tachycardia and the tachycardia itself can compromise outcome.…”

“…Une tachycardie à complexe étroit est survenue chez le second patient (cas no 2). 1 Après la médication, elle a évolué en une tachycardie à complexe large avec hypotension. Une évaluation postopératoire approfondie n'a révélé aucune anomalie.…”

“…Dans le troisième cas, la tachycardie a conduit à une douleur rétrosternale constrictive (premier épisode à survenir). 1 Les évalua-tions cardiaques ont révélé un prolapsus de la valvule mitrale avec légère régurgitation. Les palpitations sont fréquentes dans ces circonstances ; une tachycardie supraventriculaire paroxystique de réentrée est souvent observée.…”