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Cardiac complication during jugular catheter insertion in a patient with renal failure.

Author(s): Manikam RANGASAMI | Muhammad KHALIL | Jayashree RANGASAMI | Jackson Chee Seng TAN

Journal: Brunei International Medical Journal
ISSN 1560-5876

Volume: 6;
Issue: 3;
Start page: 140;
Date: 2010;
Original page

Keywords: Arrhythmia | atrioventricular block | central venous catheterisation | dialysis | heart blocks | right bundle branch block

Central venous catheterisation is a common procedure performed for emergency dialysis. It is usually carried out without any cardiac monitoring. Cardiac arrhythmias with associated conduction blocks are rare complications. The underlying pathogenesis is trauma to the endocardium by the guide wire or catheter. It occurs more frequently in patients with acute renal failure and azotaemia than patients with established end stage renal disease. Disturbances in acid base balance and electrolyte abnormalities are contributing factors. Fortunately, most are benign but occasionally can lead to potentially fatal arrhythmias. We report a case of a 46-year-old lady with end stage renal failure secondary to diabetes mellitus who developed runs of transient ventricular ectopics and right bundle branch block during internal jugular catheterisation. This spontaneously resolved 12 hours later.
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