Torsade de pointes indicates early neurologic damage in acute ischemic stroke.
Torsade de pointes (TdP) is a life-threatening polymorphic ventricular tachycardia that is related to QT prolongation. Although QT prolongation is commonly seen in acute stroke, TdP is rare. We report the case of a 78-year-old woman with ischemic stroke who presented with TdP as the initial manifestation of early neurologic deterioration. We hypothesized that an increase in intracranial pressure may result in neurohormonal activation, QT prolongation, and then myocardial damage, leading to TdP. We highlight that new onset of TdP in a patient with stroke may reflect neurologic deterioration, requiring further evaluation and specific intervention.
Department of Internal Medicine, Division of Cardiology, Armed Forces Taoyuan General Hospital, Taoyuan, Taiwan; Department of Internal Medicine, Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Li-Yen
LY
Huang
Wei-Shiang
WS
Lin
Wen-Yu
WY
Lin
Cheng-Chung
CC
Cheng
Shu-Meng
SM
Cheng
Tsung-Neng
TN
Tsai
D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000000981:diagnostic imaging; D018450:Disease Progression; D004562:Electrocardiography; D005260:Female; D006801:Humans; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016171:Torsades de Pointes / Q000209:etiology*