Hypertensive crisis-induced electrocardiographic changes: a case series

Introduction Myocardial injury is one of the most notorious complications of a hypertensive crisis. Key electrocardiograph signs used to detect cardiac injury such as ST segment changes and cardiac arrhythmias usually indicate acute ongoing end-organ damage. Lack of early signs to predict end-organ...

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Bibliographic Details
Published in:Journal of medical case reports 2009-08, Vol.3 (1), p.7283-7283
Main Authors: Farha, Khalid Abou, van Vliet, André, van Marle, Sjoerd, Vrijlandt, Patrick, Westenbrink, Daan
Format: Article
Language:English
Subjects:
Care and treatment
Case studies
Diagnosis
Electrocardiogram
Electrocardiography
Health aspects
Heart diseases
Hypertension
Research article
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Summary:Introduction Myocardial injury is one of the most notorious complications of a hypertensive crisis. Key electrocardiograph signs used to detect cardiac injury such as ST segment changes and cardiac arrhythmias usually indicate acute ongoing end-organ damage. Lack of early signs to predict end-organ damage might lead to a delay in the initiation of therapy and selection of the incorrect therapeutic strategy. Case presentation We describe five cases of tall, hyper acute symmetrical T-waves alone or accompanied by other electrocardiograph abnormalities in five healthy participants: three women aged 52, 60 and 62-years and two men aged 49 and 66-years, during a tyramine-monoamine oxidase-inhibitor interaction, phase I clinical trial. T-wave changes appeared early during the course of the hypertensive crisis and were attributed to subendocardial ischemia. The changes were transient and reverted to baseline in parallel with a fall in blood pressure. Conclusion Recognition of tall symmetrical T-waves in early phases of hypertensive crisis heralds commencement of myocardial damage. This calls for prompt medical intervention to avoid an impending irreversible myocardial injury. It is our belief that these findings will add new insight into the management of hypertensive crisis and will open avenues of further investigation.
ISSN:1752-1947
1752-1947
DOI:10.4076/1752-1947-3-7283