Teenager lost consciousness in the street

Abstract

A 15-year-old boy fell down unconscious in the street. Witnesses called an ambulance and have started resuscitation. The rescue team arrived in a few minutes and diagnosis of cardiac arrest in the course of ventricular fibrillation was established. After third defibrillation and administration of adrenaline intravenously, sinus rhythm returned and the patient was transported to the hospital to the intensive care unit. The coronary angiography revealed no anomalies in the coronary arteries. He needed 12-day respiratory therapy due to respiratory failure. Afterwards he was transferred to the Department of Paediatric Cardiology and Congenital Heart Defects for further diagnostics and treatment evaluation. According to the medical records he has been under the cardiological care since early childhood due to the diagnosis of Ebstein anomaly. Looking for a treatable cause of cardiac arrest invasive electrophysiological study (EPS) was performed. The study did not reveal any accessory atrioventricular pathway and during the study non-sustained ventricular tachycardia consisting of 13 beats was triggered. Due to the lack of treatable causes of ventricular fibrillation the patient received cardioverter-defibrillator as a secondary prevention of sudden cardiac arrest.