title: Multifactorial QT Interval Prolongation and Takotsubo Cardiomyopathy.
abstract: A 71-year-old woman collapsed while working as a grocery store cashier. CPR was performed and an AED revealed torsades de pointes (TdP). She was subsequently defibrillated resulting in restoration of sinus rhythm with a QTc interval of 544 msec. Further evaluation revealed a diagnosis of Takotsubo Cardiomyopathy (TCM) contributing to the development of a multifactorial acquired long QT syndrome (LQTS). The case highlights the role of TCM as a cause of LQTS in the setting of multiple risk factors including old age, female gender, hypokalemia, and treatment with QT prolonging medications. It also highlights the multifactorial nature of acquired LQTS and lends support to growing evidence of an association with TCM.
authors.affiliation: Department of Medicine, Kingston General Hospital, Queen's University, Kingston, ON, Canada K7L 3N6.
authors.forename: Michael
authors.identifier: 0000-0002-9897-5038
authors.initials: M
authors.lastname: Gysel
authors.affiliation: Department of Medicine, Yale University, Bridgeport Hospital, Bridgeport, CT 06610, USA.
authors.forename: Alexander
authors.identifier: 0000-0002-6534-685X
authors.initials: A
authors.lastname: Crystal
authors.affiliation: School of Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, UK.
authors.forename: Jules C
authors.initials: JC
authors.lastname: Hancox
authors.affiliation: Department of Medicine, Kingston General Hospital, Queen's University, Kingston, ON, Canada K7L 3N6.
authors.forename: Michelle
authors.identifier: 0000-0001-5138-4620
authors.initials: M
authors.lastname: Methot
authors.affiliation: Department of Medicine, Kingston General Hospital, Queen's University, Kingston, ON, Canada K7L 3N6 ; Cardiac Electrophysiology and Pacing, Kingston General Hospital, Queen's University, Kingston, ON, Canada K7L 2V7.
authors.forename: Adrian
authors.initials: A
authors.lastname: Baranchuk