Levofloxacin-induced torsades de pointes.
A 91-year-old woman, presenting with flu-like symptoms, developed a brief episode of polymorphic ventricular tachycardia in the emergency department. The arrhythmia resolved spontaneously, and a subsequent electrocardiogram revealed Q waves and ST-segment elevation in the anterior precordial leads, along with a prolonged QT interval. The presumed diagnosis was ST-segment-elevation myocardial infarction with ischemia-induced ventricular tachycardia. Emergent coronary artery angiography revealed only minimal luminal irregularities. It was discovered that the patient had been taking levofloxacin and, apparently as a result, developed drug-induced torsades de pointes. The case of this patient is an example of the difficulties that are occasionally encountered in differentiating ST-segment-elevation myocardial infarction from nonischemic ST elevation.
Patel
Parag D
PD
Department of Medicine, Section of Cardiology, Baylor College of Medicine, Houston, Texas 77030, USA.
Afshar
Hamid
H
Birnbaum
Yochai
Y
D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D064704:Levofloxacin; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D015242:Ofloxacin / Q000009:adverse effects*; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology
D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D015242:Ofloxacin
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