Pronounced QT Prolongation During General Anesthesia in a Child with Left Ventricular Noncompaction Cardiomyopathy: A Case Report
We report the case of an 8-year-old boy with left ventricular noncompaction cardiomyopathy (LVNC) and QT prolongation who experienced further prolongation of the QTc during general anesthesia for extraction of a maxillary mesiodens. Pronounced prolongation of the QTc was observed after induction of general anesthesia with thiamylal and during emergence. No notable fluctuations in blood pressure, heart rate, and estimated continuous cardiac output were observed. We considered it likely that the QT prolongation was triggered by thiamylal and increased sympathetic nervous system activity. During general anesthesia for children with LVNC and QT prolongation, it is necessary to monitor intraoperative hemodynamic fluctuations and prepare for the possible occurrence of arrhythmias.
QTc Prolongation After IV Administration of Thiamylal (A) and During Emergence (B).
Caption: (A) 1: One minute after IV administration of thiamylal (150 mg); 2: 2 minutes after IV administration of thiamylal (150 mg); 3: end of intubation. (B) 4: End of the operation; 5: extubation.
Abbreviations: IV, intravenous; HR, heart rate; QTc, corrected QT; esCCO, estimated continuous cardiac output.
Contributor Notes