title: QT interval prolongation during ECG evolution in takotsubo cardiomyopathy poses a threat of torsade de pointes to predisposed patients. Case report of a female patient with congenital AV block.
abstract: We report the case of a female patient with congenital complete atrioventricular block who developed torsade de pointes (TdP) in the course of takotsubo cardiomyopathy. On the basis of this case, we show that the electrocardiographic evolutionary changes with QT interval prolongation (in the course of takotsubo cardiomyopathy) may be a TdP threatening period in patients with underlying predispositions. After reviewing the literature, we also present the electrocardiographic similarities between takotsubo cardiomyopathy and other acute heart diseases associated with a large amount of stunned myocardium, i.e., other stress-related cardiomyopathies (e.g., those associated with subarachnoid hemorrhage, pheochromocytoma, or severe illnesses) as well as a reperfused myocardial infarction. QT interval prolongation is a common feature in the subacute phase of these entities; however, excessive QT prolongation may be a sign of predisposition to TdP. In such instances, measures should be taken to monitor cardiac rhythm closely and to prevent or treat TdP appropriately. Taking into account the risk of TdP, it is reasonable to consider takotsubo cardiomyopathy as a potential cause of acquired long QT syndrome.
authors: Department of Cardiology, Regional Medical Center , Al. Witosa 26 , 45-418 , Opole, Poland, sacha@op.pl.
authors: J
authors: J
authors: Sacha
authors: A
authors: A
authors: Wester
authors: G
authors: G
authors: Hordynski
authors: W
authors: W
authors: Pluta
mesh_terms: D054537:Atrioventricular Block / Q000150:complications / Q000151:congenital* / Q000175:diagnosis; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000175:diagnosis* / Q000209:etiology*; D012307:Risk Factors; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis*; D016171:Torsades de Pointes / Q000175:diagnosis* / Q000209:etiology*
references: J Am Coll Cardiol. 2009 Jul 7;54(2):143-9
references: 19573731
references: J Intern Med. 2006 Jan;259(1):59-69
references: 16336514
references: Am J Crit Care. 2002 Jan;11(1):48-56
references: 11785557
references: J Am Coll Cardiol. 2001 Oct;38(4):1168-74
references: 11583899
references: J Cardiovasc Electrophysiol. 2006 Dec;17(12):1340-7
references: 17096660
references: Chest. 1975 Jan;67(1):43-8
references: 1235328
references: N Engl J Med. 2005 Feb 10;352(6):539-48
references: 15703419
references: Circulation. 2008 Jul 22;118(4):397-409
references: 18645066
references: Europace. 2009 Jun;11(6):697-700
references: 19351629
references: Int J Cardiol. 2008 Aug 1;128(1):e31-3
references: 17692953
references: Chest. 2005 Jul;128(1):296-302
references: 16002949
references: Am J Physiol. 1990 Jun;258(6 Pt 2):H1796-805
references: 2163219
references: Circ J. 2007 Jun;71(6):982-5
references: 17527000
references: J Am Coll Cardiol. 2009 Apr 14;53(15):1320-5
references: 19358948
references: Int J Cardiol. 2011 Dec 15;153(3):241-8
references: 21474192
references: J Am Coll Cardiol. 2007 Jan 23;49(3):320-8
references: 17239713
references: Indian Pacing Electrophysiol J. 2008 Aug 01;8(3):182-92
references: 18679529
references: Heart Rhythm. 2004 Sep;1(3):284
references: 15851170
references: J Electrocardiol. 2009 Jul-Aug;42(4):353-357.e1
references: 19261294
references: J Cardiol. 1991;21(2):203-14
references: 1841907
references: Chest. 1998 Jul;114(1):98-105
references: 9674454
references: J Am Coll Cardiol. 2001 Jul;38(1):11-8
references: 11451258
references: Cardiology. 1996 Mar-Apr;87(2):91-7
references: 8653736
references: Heart Rhythm. 2011 Apr;8(4):555-61
references: 21146632
references: Circulation. 2012 Nov 6;126(19):e309; author reply p. e310
references: 23129706
references: Circ J. 2004 Jan;68(1):77-81
references: 14695470
references: Int J Cardiol. 2009 Aug 14;136(2):225-7
references: 18617280
references: J Cardiovasc Electrophysiol. 1995 Nov;6(11):1032-8
references: 8589872
references: J Am Soc Echocardiogr. 2010 Jul;23(7):766-71
references: 20620862