What is going on with Adenosine?-Juniper Publishers
JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Keywords: Keywords: Adenosine; Tachycardia; Paradoxical response Introduction Adenosine bolus administration is extremely valuable in the first approach to narrow-QRS tachycardia. We present two cases in which this strategy leaded to an unexpected effect. We focus on the importance of knowing this effect of the adenosine in this setting so that the maneuver is performed in an appropriate place and carried out by trained staff. Case Report Case A 73-year-old lady with hypertension, diabetes and dyslipidemia referred progressive dyspnea for two months. On physical examination, no murmurs, arrhythmia or crackles were audible. Cardiomegaly was present on the x-ray chest. ECG is performed ( Figure 1 ): narrow QRS tachycardia with low voltage. Then, a bolus of 6mg of adenosine is administered intravenously twice as a diagnostic and...