title: Severe Torsades de Pointes with acquired QT prolongation.
abstract: Torsades de pointes (TdP) is a fatal polymorphic ventricular tachycardia in association with congenital or acquired QT prolongation. Concomitant electrolyte disturbances and drugs potentiate the development of TdP. We describe a severe case of refractory TdP in the setting of methadone, cocaine, hypokalemia and hypomagnesemia. The successful treatment was achieved with the administration of magnesium, isoproterenol, and electrolyte replacement.
authors.affiliation: Section of Cardiology, Department of Medicine, University of Chicago, USA.
authors.forename: Akhil
authors.initials: A
authors.lastname: Narang
authors.affiliation: Section of Cardiology, Department of Medicine, University of Chicago, USA.
authors.forename: Cevher
authors.initials: C
authors.lastname: Ozcan
mesh_terms: D061605:Administration, Intravenous; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001569:Benzodiazepines / Q000633:toxicity*; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology; D003042:Cocaine / Q000633:toxicity*; D019560:Echocardiography, Three-Dimensional / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D053565:Hypercalciuria / Q000175:diagnosis; D007008:Hypokalemia / Q000175:diagnosis; D007262:Infusions, Intravenous; D007545:Isoproterenol / Q000008:administration & dosage / Q000627:therapeutic use; D008133:Long QT Syndrome / Q000209:etiology* / Q000503:physiopathology; D008278:Magnesium Sulfate / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D009397:Nephrocalcinosis / Q000175:diagnosis; D011188:Potassium / Q000008:administration & dosage / Q000627:therapeutic use; D015499:Renal Tubular Transport, Inborn Errors / Q000175:diagnosis; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000150:complications* / Q000188:drug therapy / Q000534:rehabilitation; D013566:Sympathomimetics / Q000008:administration & dosage / Q000627:therapeutic use; D016171:Torsades de Pointes / Q000139:chemically induced / Q000175:diagnosis* / Q000503:physiopathology; D016896:Treatment Outcome; D014882:Water-Electrolyte Balance / Q000187:drug effects
chemical_list: D000889:Anti-Arrhythmia Agents; D013566:Sympathomimetics; D001569:Benzodiazepines; D008278:Magnesium Sulfate; D003042:Cocaine; D007545:Isoproterenol; D011188:Potassium
keywords: QT interval; Torsades de pointes; acute cardiovascular care; arrhythmia; cardiac electrophysiology; drug abuse; electrolytes