January 2019 Critical Care Case of the Month: A 32-Year-Old Woman with Cardiac Arrest

Sarah A. Watkins, DO¹

Geoffrey Smelski, PharmD¹

Robert N.E. French, MD¹

Michael Insel, MD²

Janet Campion MD²

¹Arizona Poison and Drug Information Center and ²Division of Pulmonary, Allergy, Critical Care and Sleep

University of Arizona

Tucson, AZ USA

History of Present Illness

A 32-year-old woman with history of chronic neck pain and opioid abuse complained of dizziness and palpitations shortly before suffering a witnessed cardiac arrest in her home. She was given bystander cardiopulmonary resuscitation until emergency medical services arrived on scene, at which point intermittent polymorphic ventricular tachycardia with a pulse was noted on the cardiac monitor and physical exam (Figure 1).

Figure 1. Rhythm strips showing ventricular tachycardia (A) and a prolonged QT interval (B).

Which of the following is (are) the most likely cause(s) of the cardiac arrythmia? (Click on the correct answer to be directed to the second of seven pages)

1. Cardiomyopathy
2. Coronary artery disease
3. Drug-induced arrythmia
4. 1 and 3
5. All of the above

Cite as: Watkins SA, Smelski G, French RNE, Insel M, Campion J. January 2019 critical care case of the month: A 32-year-old woman with cardiac arrest. Southwest J Pulm Crit Care. 2019;18(1):1-7. doi: https://doi.org/10.13175/swjpcc121-18 PDF