Fatal monomorphic ventricular tachycardia in a semi-urban setting in Cameroon: a case report

Clovis Nkoke, Engelbert Bain Luchuo, Laetitia Dikoume

Ventricular tachycardia is a life threatening cardiac arrhythmia. It needs management with defibrillation, without which, immediate death may occur. A 66 year old black African patient with a 2 year history of hypertension was admitted to the emergency department of the Buea Regional hospital, a semi-urban setting in Cameroon, after presenting with syncope while in church. The wife described a similar episode 2 weeks prior without any further evaluation. Upon arrival at the emergency, patient had regained consciousness but lethargic, tachypneic and diaphoretic. The blood pressure was 85/61 mmHg; the pulse was 219/min, weak and thready. He had cold extremities. A 12 lead electrocardiogram performed showed a sustained monomorphic ventricular tachycardia at 230/min. He was administered six tablets of amiodarone, oxygen by nasal cannula and intravenous fluids. No electrical cardioversion was attempted due to the non availability of a defibrillator. Outcome was fatal with death of the patient 30 min after his arrival to the emergency. Our health facilities should be well equipped for resuscitative measures by adopting Advanced Cardiac Life Support as cardiovascular diseases are becoming more frequent in our settings.