Case

Case :
A 36 years old female, came to RSPAD with heart palpitations and shortness of breath. This is
experienced by patient since 3 days before entered the hospital. Patient had been diagnosed with HIV
since 3 years ago and consumpted of antiretroviral drugs. Patient often feels heart palpitations and the
complaints are more heavier in these 3 days. Patient consumes Lamivudine 150 mg twice a day and
Efavirenz 600 mg once a day routinely. The blood : 110/80 mmHg, heart rate : 130 bpm, respiratory
rate : 30 breath per minute. The other physical examinations were normal . At the ECG examination
was found monomorphic Ventricular Tachycardia with rates 200x/minute. (Figure 1,2)

The patient was treated with Amiodarone 150 mg injection in 10 minutes, followed by Amiodarone 900
mg IV maintenance in 24 hours (360 mg in the first 8 hours followed by 540 mg in the next 16 hours).
Then the patient performed a repeat ECG examination and the results was Sinus Rhytm and QT-
Prolongation (corrected QT interval 558 ms) (Figure 3). Laboratory and x-ray results were within
normal limits. Examination of echocardiography has not found any structural and functional heart
abnormalities. Antiretroviral therapy was stopped, two days later, Qtc had decreased with no futher
episodes of VT (Figure 4). Then the patient was discharged from hospital and will control on VCT
polyclinic .

Figure 1. ECG in Emergency Room

Ventricular Tachycardia Monomorphic

Figure 2. ECG in Emergency Room

Ventricular Tachycardia Monomorphic

Figure 3. ECG after administered Amiodarone injection

(Sinus Rythm, rate 75 bpm, axis normal, P wave normal, QRS duration 0.06s, ST changes (-), Qtc
 interval 558 ms

Figure 4.
ECG 2nd day in Intermediate Care Unit
((Sinus Rythm, rate 75 bpm, axis normal, P wave normal, QRS duration 0.06s, ST changes (-), Qtc
interval 511 ms)