Hashem, Anas Mohamad
Al Ali, Omar
Khalouf, Amani
Shehadah, Ahmed
Mohammed, Moghniuddin
Mahmoud, Amir
Laguio-Vila, Maryrose
Rao, Mohan
Article History
Received: 7 February 2023
Accepted: 30 June 2023
First Online: 14 July 2023
Declarations
:
: The authors confirm that written consent for submission and publication of this case report including image(s) and associated text has been obtained from the patient’s next of kin in line with COPE guidance.
: We attest that informed consent was obtained from the patient’s next of kin for publication of identifying information/images in an online open-access publication.
: The authors declare no potential conflict of interest.
: 2014: Diagnosed with atrial fibrillation, treated with metoprolol. June/2021: Patient developed tachycardia-induced cardiomyopathy, underwent electrocardioversion. Unsuccessful. July/2021: She underwent catheter ablation for recurrent atrial fibrillation, reverted to normal sinus rhythm. September/2021 (Day 1 of admission): She presented with sudden onset of dyspnea and palpitations, diagnosed with atrial fibrillation and rapid ventricular response requiring cardioversion. Initiated on pharmacological cardioversion and then advanced to electrical cardioversion. She decompensated and bedside TTE showed severe global hypokinesis with ventricular stunning. She was diagnosed with cardiogenic shock and placed on pressors. Day 2: Left and Right heart catheterization showed normal coronary arteries with moderate pulmonary hypertension, low CO/CI and elevated SVR confirming cardiogenic shock. Patient was placed on IABP. Day 3: Due to lack of hemodynamic improvement, patient was switched to Impella 2.5 instead of IABP. Patient was maximized on pressors. Day 4: Goals of care discussion with the family, they pursued comfort care measures and patient ultimately passed away.