A case of torsade de pointes and ventricular fibrillation caused by congenital long QT syndrome with hypokalemia as impending emergency

DOI 6 References
  • Sunami Kazuharu
    <I>Department of Internal medicine, Okayama kyoritsu Hospital</I>
  • Kato Tadahiko
    <I>Department of Internal medicine, Okayama kyoritsu Hospital</I>
  • Ohno Masanori
    <I>Department of Internal medicine, Okayama kyoritsu Hospital</I>

Bibliographic Information

Other Title
  • 失神で来院しｔｏｒｓａｄｅ　ｄｅ　ｐｏｉｎｔｅｓを繰り返したＱＴ延長症候群の１症例

Search this article

Abstract

A 62-year-old woman with syncope was transferred to our emergency room. Electrocardiogram (ECG) showed a marked QT prolongation (QTc 680 ms) with a notch in the T wave. The serum potassium concentration was 2.8 mmol per liter. The patient was admitted to ICU because we judged this QT prolongation indicated an impending emergency. On the electrocardial monitoring, an extrasystole generated as R on T wave, which developed torsade de pointes (TdP) and ventricular fibrillation (VF) . Repeated countershock was required for defibrillation. Intravenous administration of magnesium effectively suppressed the ventricular arrhythmias. However, the QTc interval shortened by 520 ms as the serum potassium concentration improved, and the patient was finally diagnosed the congenital long QT syndrome because her sister and brother had both died suddenly when young and her son's ECG showed QT prolongation. We consider that constant electrocardial monitoring and prompt treatment for VF in ICU were important factors in life-saving. It is necessary to evaluate the causes of QT prolongation and the possibility of development to TdP and VF in the emergency room.

Journal

References(6)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top