Ventricular tachycardia (VT) is one of the most common arrhythmias during the acute phase of myocardial infarction (MI). It is a regular wide-QRS tachycardia with atrioventricular dissociation and often carries a guarded prognosis. Few studies in Niger have addressed arrhythmias in the acute phase of MI. We report a case of sustained VT revealing MI at Amirou Boubacar Diallo National Hospital (HNABD) in Niamey. Casereport: A 63-year-old male patient with cardiovascular risk factors (age, male sex, poorly controlled diabetes mellitus on metformin for >10 years) was admitted to our department of internal medicine and cardiology for palpitations and exertional dyspnea. Clinical and complementary investigations established the diagnosis of MI complicated by sustained VT and an apical thrombus. After failure of properly conducted chemical cardioversion, the patient finally underwent electrical cardioversion with a 100-joule shock, restoring sinus rhythm. Immediate outcome was marked by hemodynamic and respiratory instability requiring intubation. The patient was urgently transferred to Morocco, where coronary angiography demonstrated occlusion of the left anterior descending artery (LAD), which was successfully stented with favorable outcome. Conclusion: Ventricular tachycardia is a severe complication of acute coronary syndrome (ACS) and is generally terminated by electrical cardioversion.
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