Unique Treatment of Ventricular Tachycardia Storm in a Patient With Cervical Spine and Chest Wall Injuries

Abstract

Ventricular tachycardia storm (VTS/ES) is defined as the occurrence of three or more episodes of sustained ventricular tachycardia within a twenty-four-hour period, with or without a defibrillator. It has not been reported de novo in trauma patients. The literature indicates blunt cardiac injury as a potential etiology of ventricular dysrhythmia. We present a patient with a history of atrial fibrillation and a cardiac resynchronization device with defibrillator who presented neurologically intact with cervical vertebral, internal, and bony thoracic injuries following a ground level fall. Within 24 hours, the patient developed VTS/ES that was ultimately resolved with a stellate ganglion block. This is the first report of a trauma patient with suspected blunt cardiac injury undergoing a stellate ganglion block following the onset of VTS/ES. Blunt cardiac injury is worth consideration as an etiology in post-trauma patients with ventricular tachycardia storm, particularly when no other source is identified. Stellate ganglion block, which can be performed at bedside with appropriate specialist availability, can be considered among treatment options in trauma patients.