1/7. Fatal case of delayed repolarization due to cocaine abuse and global ischemia.When a previously healthy, middle-aged patient presents with apparent seizures, what should alert the physician to the possibility of underlying cardiac disease? This report describes a case of long qt syndrome, initially presenting as seizures, which expressed itself at an atypically advanced age as a result of cocaine use, global myocardial ischemia, and ventricular tachycardia.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. Short QT syndrome: a case report and review of literature.The short QT syndrome has been recently recognised as a genetic ion channel dysfunction. This new clinical entity is associated with an incidence of sudden cardiac death, syncope, and atrial fibrillation in otherwise healthy individuals. The distinctive ECG pattern consists of an abnormally short QT interval, a short or even absent ST segment and narrow T waves. A 30-year-old resuscitated woman with short QT syndrome is described together with an example of the classic ECG characteristics. A short-coupled variant of torsade de pointes was reveal on Holter recordings. The implantable cardioveter defibrillator seems to be the therapy of choice to prevent from sudden cardiac death. quinidine proved to be efficient in prolonging the QT interval and rendering ventricular tachyarrhythmias non-inducible in patients with a mutation in KCNH2 (HERG). Our preliminary data suggest amiodarone combined with beta-blocker may be helpful in treating episodes of polymorphic ventricular tachycardia for patients with an unknown genotype. Because the short QT syndrome often involves young patients with an apparently normal heart, it is imperative for physicians to recognize the clinical features of the short QT syndrome in making a timely correct diagnosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. A twist on torsade: a prolonged QT interval on methadone.A woman developed a prolonged QT interval and torsade de pointes while on methadone treatment for heroin addiction. We think methadone, or its impaired metabolism, was the major cause for her prolonged QT interval and progression to torsade. However, torsade is often multifactorial, as was likely so in this case. We advise physicians treating patients taking methadone to obtain careful medication and drug-use histories, screen for risk factors associated with long qt syndrome, counsel patients about potential drug interactions, and measure the QT interval before and during methadone treatment in high-risk patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. erythromycin induced torsades de pointes.erythromycin is a widely used antibiotic in today's armamentarium of antibiotics. Although erythromycin induced ventricular tachyarrhythmia is rare, this potentially life-threatening reaction should be kept in mind. The relative rarity of 'torsades de pointes' arrhythmia suggests that other predisposing factors contribute to the acquired long qt syndrome. Since more and more macrolide products have been approved by the food and Drug Administration for use in the united states, the potential problem with 'torsades de pointes' may exist with each of the macrolide antibiotic. Until the exact mechanisms of the arrhythmia are worked out, close monitoring of rhythms and QT intervals of high risk patients who require erythromycin is certainly advisable. Only a heightened awareness among the physicians and medical personnel can the adverse outcome be minimized.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. torsades de pointes induced by erythromycin.We describe two patients who develop torsades de pointes in a temporal relationship to the intravenous administration of erythromycin lactobionate in the absence of other drugs or metabolic abnormalities known to cause the arrhythmia. We also review the current literature regarding this topic, including other case histories and the evidence for erythromycin's effect on cardiac tissue. Due to the increasing use of erythromycin in clinical practice, we believe it is important that all physicians be made aware of this potential complication, which was not recognized at our institutions until these patients were seen by one of us (B.G.).- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. A review of erythromycin-induced malignant tachyarrhythmia--torsade de pointes. A case report.The term torsade de pointes refers to a ventricular tachycardia characterized by QRS complexes of changing amplitude that appears to twist around the isoelectric line and occurs at rates of 200-250/minute. Most cases of torsade de pointes are iatrogenically induced by drugs or electrolyte abnormalities. The most important feature is QT interval prolongation. Torsade de pointes was first described in 1966 in france by Dessertenne. The authors report a case of a fifty-year-old woman with medical history of corrective surgery for tetralogy of fallot who was admitted to the hospital with pneumonia and atrial fibrillation and later developed recurrent episodes of polymorphic ventricular tachycardia with QT interval prolongation after i.v. administration of erythromycin. The episodes did not recur after discontinuation of erythromycin, and the QT interval returned to normal. The association of erythromycin with torsade de pointes has been reported in 18 cases to date. erythromycin has been shown to produce electrophysiologic effects similar to those of class Ia and class III antiarrhythmic drugs on the cardiac muscle. This potentially fatal complication of a commonly used antibiotic is rare, but increased physician awareness is important, especially in patients with predisposing factors like electrolytes abnormalities, use of class Ia and Class III antiarrhythmic drugs, and presence of prolonged QT interval (congenital prolonged QT syndromes). This is the second case reported in a patient with previous cardiac surgery and erythromycin administration.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. Q-T interval prolongation and pleomorphic ventricular tachyarrhythmia ('Torsade de pointes') in organophosphate poisoning: report of a case.1. A 63-year-old woman presented with drowsy consciousness and dyspnea, followed by respiratory failure, after taking a bottle of parathion for suicide. 2. Sinus tachycardia was noted initially by ECG and Q-T interval prolongation with pleomorphic ventricular tachyarrhythmia ('Torsade de pointes') occurred on the third day of admission. 3. Torsade de pointes was relieved by magnesium sulfate and atropine sulfate intravenously. Q-T interval returned to normal on the fifth day of admission. 4. Practicing physicians should be aware of this uncommon type of cardiac toxicity caused by organophosphate poisoning, Q-T interval prolongation and pleomorphic ventricular tachyarrhythmia.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |