Cases reported "Torsades de Pointes"

Filter by keywords:



Filtering documents. Please wait...

1/13. Torsade de pointes ventricular tachycardia during low dose intermittent dobutamine treatment in a patient with dilated cardiomyopathy and congestive heart failure.

    The authors describe the case of a 56-year-old woman with chronic, severe heart failure secondary to dilated cardiomyopathy and absence of significant ventricular arrhythmias who developed QT prolongation and torsade de pointes ventricular tachycardia during one cycle of intermittent low dose (2.5 mcg/kg per min) dobutamine. This report of torsade de pointes ventricular tachycardia during intermittent dobutamine supports the hypothesis that unpredictable fatal arrhythmias may occur even with low doses and in patients with no history of significant rhythm disturbances. The mechanisms of proarrhythmic effects of Dubutamine are discussed.
- - - - - - - - - -
ranking = 1
keywords = cardiomyopathy
(Clic here for more details about this article)

2/13. torsades de pointes in a case of hypertrophic cardiomyopathy with special reference to the pathologic findings of the heart including the conduction system.

    A clinicopathologic study was performed in a 77-year-old female with hypertrophic cardiomyopathy who had experienced recurrent syncopal attacks due to Torsades de Pointes (TdP) following QT prolongation and atrioventricular block. She died suddenly two years later while eating dinner. Pathologic findings of the heart showed a dilated and hypertrophied left ventricle. The heart weighed 550 g. There were two foci of localized endocardial fibroelastosis (EFE) beneath the aortic valve, one with a size of 3.5 x 3.5 cm, and the other (2 x 1 cm) located on the upper ventricular septum. Histologic findings showed hypertrophy and disarray in the left ventricular myocardium. The conduction system using serial sectioning revealed remarkable bilateral bundle branch fibrosis and hypertrophied purkinje fibers in the left bundle branch adjacent to the EFE on the ventricular septum. These findings were thought to be related to the occurrence of TdP.
- - - - - - - - - -
ranking = 1
keywords = cardiomyopathy
(Clic here for more details about this article)

3/13. Transient QT prolongation with torsades de pointes tachycardia after ablation of permanent junctional reciprocating tachycardia.

    INTRODUCTION: catheter ablation with radiofrequency energy is a curative therapy in patients with permanent junctional reciprocating tachycardia (PJRT). methods AND RESULTS: For the first time, we report a case of transient QT prolongation with torsades de pointes tachycardia 18 hours after successful radiofrequency energy ablation of PJRT in a 25-year-old woman with tachycardia-induced cardiomyopathy. Of note, the torsades de pointes occurred in the absence of bradycardia, electrolyte disturbances, or QT-prolonging drugs. This patient initially was thought to have a hereditary long qt syndrome that was unmasked by PJRT ablation. Therefore, the patient received an implantable defibrillator in addition to beta-blocker therapy, which was discontinued 6 months later. Surprisingly, the QT interval completely normalized within 1 week after PJRT ablation, and the patient remained free of arrhythmias during a follow-up period of 4.5 years. CONCLUSION: patients with incessant tachyarrhythmias should undergo ECG monitoring for at least 24 hours following successful radiofrequency catheter ablation because transient QT prolongation with torsades de pointes may occur even in the absence of bradycardia, QT-prolonging drugs, or electrolyte disturbances.
- - - - - - - - - -
ranking = 0.2
keywords = cardiomyopathy
(Clic here for more details about this article)

4/13. Torsade de pointes induced by intravenous and long-term oral amiodarone therapy in a patient with dilated cardiomyopathy.

    A 70-year-old woman with dilated cardiomyopathy and ventricular tachyarrhythmia was initially treated in 1990 with intravenous amiodarone (240 mg). She developed a junctional escape rhythm (48 beats/min) with QT prolongation (QT: 0.68 s) and 8 h later developed torsade de pointes (TdP). Because other antiarrhythmic drugs did not suppress the arrhythmia, oral amiodarone (100 mg/day) was started in 1995, 7 weeks before she presented with congestive heart failure. The QT prolongation (QTc: 0.64) increased after administration of dopamine, and TdP again developed. This case suggests that amiodarone induces proarrhythmias by different mechanisms when administered intravenously or orally.
- - - - - - - - - -
ranking = 1
keywords = cardiomyopathy
(Clic here for more details about this article)

5/13. fluconazole-induced torsade de pointes.

    OBJECTIVE: To present a case of fluconazole-associated torsade de pointes (TDP) and discuss fluconazole's role in causing TDP. CASE SUMMARY: A 68-year-old white woman with candida glabrata isolated from a presacral abscess developed TDP eight days after commencing oral fluconazole The patient had no other risk factors for TDP, including coronary artery disease, cardiomyopathy, congestive heart failure, and electrolyte abnormalities There was a temporal association between the initiation of fluconazole and TDP. The TDP resolved when fluconazole was discontinued; however, the patient continued to have premature ventricular contractions and nonsustained ventricular tachycardia (NSVT) until six days after drug cessation DISCUSSION: Use of the Naranjo probability scale indicates a probable relationship between the use of fluconazole and the development of TDP. The possible mechanism is depression of rapidly activating delayed rectifier potassium currents. In our patient, there was no other etiology identified that could explain QT prolongation or TDP The complete disappearance of NSVT and premature ventricular contractions followed by normalization of QT interval after the drug was stopped strongly suggests fluconazole as the etiology. CONCLUSIONS: Clinicians should be aware that fluconazole, even at low doses, may cause prolongation of the QT interval, leading to TDP. Serial electrocardiographic monitoring may be considered when fluconazole is administered in patients who are at risk for ventricular arrhythmias.
- - - - - - - - - -
ranking = 0.2
keywords = cardiomyopathy
(Clic here for more details about this article)

6/13. amiodarone-induced torsade de pointes in a child with dilated cardiomyopathy.

    amiodarone has a high incidence of side effects, but few pro-arrhythmic effects. We report a case of amiodarone-induced torsade de pointes in a child aged 10 years. The patient had severe dilated cardiomyopathy, and even though he was treated with low oral doses of amiodarone, without dosage increments and electrolyte imbalance, he developed torsade de pointes at nights, after T-wave modification and increases of the corrected QT interval (QTc, 20%), QT dispersion (QTd, 175%) and QTcd (116%). The arrhythmic events were preceded by sinus bradycardia at Holter monitoring. amiodarone therapy was discontinued. Intravenous magnesium administration was not effective in the suppression of torsade de pointes. High-rate atrial pacing prevented recurrences of the arrhythmias and reduced the QTc interval by 20%, QTd by 50%, and QTcd by 70%; QTd and QTcd returned below normal limits. This case underscores the need of careful electrocardiographic monitoring during amiodarone therapy.
- - - - - - - - - -
ranking = 1
keywords = cardiomyopathy
(Clic here for more details about this article)

7/13. Torsade de pointes in a case of pheochromocytoma--an unusual presentation of an uncommon disease.

    We report the case of a middle aged lady with dilated cardiomyopathy, presenting with recurrent syncope due to torsade de pointes. Further evaluation revealed that she had a pheochromocytoma which caused the arrhythmia.
- - - - - - - - - -
ranking = 0.2
keywords = cardiomyopathy
(Clic here for more details about this article)

8/13. long qt syndrome and torsade de pointes in transient left ventricular apical ballooning syndrome.

    A recently reported cardiac syndrome of reversible left ventricular apical ballooning, also called takotsubo cardiomyopathy or ampulla cardiomyopathy, clinically resembles acute myocardial infarction and presents with chest pain, anterior electrocardiographic changes and minimal elevation of cardiac enzymes in absence of myocardial ischemia or injury. Left ventricular function recovers completely in days to weeks. This syndrome is likely a non-ischemic, metabolic-dependent syndrome caused by stress-induced activation of the cardiac adrenoceptors, and results in markedly abnormal ventricular repolarization. Reported here is a case of left ventricular apical ballooning syndrome with QT interval prolongation in a young man who developed torsade de pointes and experienced aborted sudden cardiac death. Patient had a complete recovery of cardiac function and normalization of QT interval in a few days. The syndrome of transient left ventricular apical ballooning could be considered among the causes of long qt syndrome and torsade de pointes.
- - - - - - - - - -
ranking = 0.4
keywords = cardiomyopathy
(Clic here for more details about this article)

9/13. Dilated cardiomyopathy masquerading as long qt syndrome.

    atrioventricular block has been described in association with cases of long qt syndrome and mortality is increased in this subgroup. We describe an infant with congenital QT prolongation and atrioventricular block with normal cardiac function, leading to the initial diagnosis of long qt syndrome. She subsequently developed dilated cardiomyopathy requiring cardiac transplantation. We postulate that the presenting electrocardiograph abnormalities were early manifestations of the myocardial disease, preceding the development of myocardial dysfunction by several months. The need for heightened surveillance in cases of QT prolongation with atrioventricular block is amplified by the possibility of an evolving cardiomyopathy.
- - - - - - - - - -
ranking = 1.2
keywords = cardiomyopathy
(Clic here for more details about this article)

10/13. Two cases of acute promyelocytic leukemia complicated by torsade de pointes during arsenic trioxide therapy.

    We describe 2 patients with acute promyelocytic leukemia (APL) in whom torsade de pointes (TdP) developed during treatment with arsenic trioxide. Patient 1 was a 23-year-old woman with second-relapse APL. Ventricular premature beat bigeminy developed on day 27 of treatment, and episodes of TdP developed on day 28. Patient 2 was a 51-year-old woman with second-relapse APL who had cardiomyopathy due to prior anthracycline treatment. TdP developed on day 17 of treatment. arsenic trioxide is known to cause electrocardiographic abnormalities, such as ventricular tachycardia and prolongation of QT interval. Patient 1 was given fluconazole as a concomitant drug. Patient 2 had cardiomyopathy and hypokalemia. Careful management is needed during arsenic trioxide therapy because this treatment prolongs the QT interval, possibly inducing episodes of TdP.
- - - - - - - - - -
ranking = 0.4
keywords = cardiomyopathy
(Clic here for more details about this article)
| Next ->


Leave a message about 'Torsades de Pointes'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.