Case 1
This ECG was texted to me last week with the question: “What is this??”
What do you think?
My answer: “This is a pre-torsades EKG. Watch out! Every other beat, a PVC, has an extremely long QT. In my experience, patients with ECGs like this are at very high risk of TORSADES. I have seen this several times.”
Outcome
It came from a patient who had been falling much, had a K of 2.8, and is on methadone but taking too much. The patient then received K and Mg. Torsades did not ensue. The ECG findings resolved after metabolism of methadone and K replenishment.
See several similar cases below, all of which were recorded before, during, or after Torsades de Pointes.
Case 2. Polymorphic Ventricular Tachycardia
This patient was also on Methadone. She had this 12-lead recorded immediately before the above one:
Torsades de Pointes
Case 3
Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management
Case 3, 8 minutes later
Case 3, later
Case 3, later
Case 3, later
Case 3, later
Case 3, later
Case 4, had Torsades after these ECGs
Same patient as “case 4,” a bit later
See these posts:
