Kosin Medical Journal

Sun Hack Lee

2 Articles

Development of severe junctional bradycardia after dexmedetomidine infusion in a polypharmacy patient: a case report and literature review: Soeun Jeon, Eunsoo Kim, Sun Hack Lee, Sung In Paek, Hyun-Su Ri, Dowon Lee; Kosin Med J. 2023;38(1):50-55. Published online December 7, 2022; DOI: https://doi.org/10.7180/kmj.22.113

Abstract PDF PubReader ePub: The authors report a case of newly manifested severe junctional bradycardia following dexmedetomidine administration during spinal anesthesia in a polypharmacy patient. A 77-year-old woman receiving multiple medications, including a beta-blocker and a calcium channel blocker, underwent right total knee arthroplasty. After spinal anesthesia, intravenous dexmedetomidine was initiated as a sedative; her heart rate decreased, followed by junctional bradycardia (heart rate, 37–41 beats/min). Dexmedetomidine was discontinued, and a dopamine infusion was initiated. Seven hours after surgery, junctional bradycardia persisted; a temporary transvenous pacemaker was inserted, and the beta-blocker and calcium channel blocker were discontinued. The patient was discharged on postoperative day 11 without any sequelae. Anesthesiologists should be aware of dexmedetomidine’s inhibitory effects on the cardiac conduction system, especially in geriatric patients taking medications with negative chronotropic effects and in combination with neuraxial anesthesia.

Right Atrial Blood Cyst Mimicking a Vegetative Mass: Sun Hack Lee, Jung Hyun Choi; Kosin Med J. 2021;36(1):40-43. Published online June 30, 2021; DOI: https://doi.org/10.7180/kmj.2021.36.1.40

Abstract PDF PubReader ePub: A 79-year-old woman presented to another hospital with complaints of right leg pain. Computed tomography and magnetic resonance imaging of the spine was performed in the other hospital, which showed an abscess in the right iliacus muscle. She was referred to our hospital because of a mass in the right atrium on echocardiography. Inflammatory markers were elevated, and Staphylococcus aureus were identified in blood cultures. Transthoracic echocardiography revealed a shaggy mass in the right atrium that resembled vegetation. Transesophageal echocardiography showed a large cystic mass with a hyperechoic lesion. After surgery, biopsy results indicated that it was a myxoid mass with cystic changes.

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