We not absent herein a case of cough-induced nonsustained ventricular tachycardia for which we set up no definitive explanation.

We not absent herein a case of cough-induced nonsustained ventricular tachycardia for which we set up no definitive explanation. It could be an anomaly, however this so far unreported clinical fact is worth noting. Notwithstanding this interesting case, we believe that cough can be praiseed as a safe and efficacious technique for overcoming hypotensive cardiac arrhythmias.

Coughing has been praiseed as a safe and efficacious technique for overcoming ventricular tachycardia (VT) A intelligent forceful cough can be used as an effective resuscitative technique during hypotensive VT and hypotension.[1-3] It has been shown that it helps in altering the strict bradycardia and hypotension that may come into one's head after intracoronary injections of contrast medium.[2]

In an exceptional case, a 66-year-old woman was establish to have episodes of nonsustained ventricular tachycardia (NSVT) following coughing attacks. We at hand herein a case report in which cough caused NSVT

CASE REPORT

A 66-year-old woman currented at the Intensive Care Cardiac Unit with NSVT during coughing attacks (Fig 1)

Physical examination revealed the following: progeny pressure 120/78 mm Hg; beating [i]or[/i] throbbing of an artery 72 and regular; heart, normal; and mild wheezing in the lung ensues from ECG, chest radiograph, vital current gases, and routine blood standards were within normal limits. Doppler echocardiography showed a normal heart. Ergometry induced NSVT in the next to the first minute of the Bruce protocol.

Cardiac angiography revealed normal coronary arteries and normal left ventricular function. Electrophysiologic reflection was planned but the patient refused further investigation.

DISCUSSION

The use of coughing as a tool for conversion of VT has been known for many years. It has been insinuateed that coughing could help as a form of "cardiac massage," becoming to the intrathoracic pressure it induces.

Wei et al[2] allude to that there are several advantages to cough-induced cardiac compression across external massage: the procedure is simple and can be self-induced; it does not lead to traumatic complications or possible damage to ribs or sternum; and it can be carried revealed anywhere and in any position.

Sakai and Mori[4] reported a case of "schlucktachycardia" in 1926 Omari et al[5] were the first to report a case of cough-induced tachyarrhythmia. To the best of our knowledge, this is the first report of NSVT precipitated through cough.

While coughing, the intrathoracic influence becomes elevated and can increase to 450 mm Hg The linear air velocity is 50 to 120 m/ and can rise as high as 280 m/ approaching the spe of whole The amount of air expired during a cough ranges normally from 1 to 3 L From these values, united can estimate the amount of kinetic efficiency generated as approximately 1 to 25 J[2] thus, strictly forward the basis of energy considerations, it may be feasible for cough to about sufficient mechanical energy to cause cardiac depolarization.[5] We erect no common pathophysiologic mechanism to convincingly explain the precipitation of NSVT during cough and exercise. However, it is possible that increased air linear velocity in the pair exercise and coughing could stimulate the larynx, causing retroactive NSVT.

REFERENCES

[1] Miller B Lesnefsky E Heyborne T Schmidt B Freeman K Breckinridge s et al. Cough-cardiopulmonary resuscitation in the cardiac catheterization laboratory: hemodynamics during an episode of defered hypotensive ventricular tachycardia. Cathet Cardiovasc Diagn 1989; 18:168-71

[2] Wei JE Greene LE Weisfeldt MY. Cough-facilitated conversion of ventricular tachycardia. Am J Cardiol 1980; 45:174-76

[3] Schultz DD Olivas O The use of cough cardiopulmonary resuscitation in clinical practice. Heart Lung 1986; 15:273-80

[4] Sakai D Mori F Ueber einen Fall von slog Schlucktachycardie. Z Gesamte Exp M 1926; 50:106

[5] Omari JR Yamada CH Inue DA, Katsume HJ Ijichi HA. Tachyarrhythmia provok through coughing and other stimuli. Chest 1984; 5:797-99

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