Acute and Critical Care

Case Reports

Cardiology
Torsades de Pointes during Treatment of Tachycardia-Induced Cardiomyopathy: Dong Kyu Lee, Il Hwan Ryu, Ji Hyung Yoo, Su A Yun, Sang Hyun Park, Ki Woon Kang, Won Ho Kim, Yu Jeong Choi, Kyung Tae Jung, Jung Yeon Chin; Korean J Crit Care Med. 2014;29(1):19-22. Published online February 28, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.1.19

Abstract PDF: Tachycardia-induced cardiomyopathy is caused by persistent tarchyarrhythmias and is characterized by ventricular systolic dysfunction and congestive heart failure. Tachycardia-induced cardiomyopathy is usually reversible via treatment. The cornerstone in the management of disease in these patients is to achieve a normal heart rate. We report a torsades de pointes during treatment of tachycardia-induced cardiomyopathy. Intravenous magnesium sulfate and potassium were administrated, but torsades de pointes was repeated. After overdrive right ventricular pacing, torsades de pointes was terminated. Careful monitoring of the QT interval and serum electrolyte and drug levels in such patients is warranted during treatment of tachycardia-induced cardiomyopathy.

A Case of Stress Cardiomyopathy Complicated by Torsades de Pointes in a Patient with Acute Colitis: A Case Report: Hyoungyoung Kim, Gi Byoung Nam, Sang Jin Lee, Hyun Kee Lee, Yoonki Hong, Kee Joon Choi, You Ho Kim; Korean J Crit Care Med. 2007;22(2):101-105.

Abstract PDF: A 67-year old woman, hospitalized for the management of infectious colitis, developed acute congestive heart failure. Two-dimensional echocardiography revealed left ventricular apical akinesia (ballooning) and basal hyperkinesis, which was compatible with stress cardiomyopathy. A marked QT prolongation and T wave inversion followed by nonsustained polymorphic ventricular tachycardia was noted in the electrocardiogram. Intravenous administration of magnesium completely suppressed the ventricular tachycardia. After recovery from the colitis, the follow-up ECG and echocardiogram were normalized. There was no evidence of ischemic heart disease in the coronary angiography or perfusion scan. Takotsubo cardiomyopathy is one of the most important causes of acquired QT prolongation in ICU (intensive care unit) patients.. A careful monitoring of the QT interval in these patients is warranted particularly when drugs causing QT prolongation are used.

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