ABSTRACT

Case: A 34-year-old woman with no significant past medical history presented to the hospital with sudden onset of palpitations with associated dyspnea and chest discomfort. She denied any similar previous episodes. Initial electrocardiogram (EKG) was consistent with a short R-P interval supraventricular tachycardia (SVT). Her transthoracic echocardiogram (TTE) revealed no structural abnormalities, TSH levels were normal, and urine drug screen was negative for any recreational drugs. However, the patient had been taking phentermine for weight loss.

Discussion: The exact mechanism is not clear; however, we postulate that the sympathomimetic effects of phentermine likely contribute to SVT induction through enhanced AV nodal conduction or increased atrial ectopy. 

Conclusions: The only medication she was taking at home was phentermine, and the palpitations did not recur after discontinuation of the drug during follow-up. It is important to collect a thorough medication history when patients present with AV nodal reentrant tachycardia (AVNRT) or other SVT.

摘要

病例：一名34岁，无明显病史的妇女就诊于医院，心sudden突然发作，伴有呼吸困难和胸部不适。她否认有过类似的前几集。最初的心电图（EKG）与短的RP间隔室上性心动过速（SVT）一致。她的经胸超声心动图（TTE）没有发现结构异常，TSH水平正常，尿液筛查对所有休闲药物均呈阴性。但是，该患者一直在服用芬特明以减轻体重。

讨论：确切的机理尚不清楚；然而，我们推测芬特明的拟交感神经作用可能通过增强的AV淋巴结传导或增加的心房异位促成SVT的诱导。 

结论：她在家服用的唯一药物是芬特明，随访期间停药后心pit未复发。当患者出现房室结折返性心动过速（AVNRT）或其他SVT时，收集彻底的用药史很重要。