Ventricular tachycardia laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Serial cardiac enzymes, serum electrolytes as well as calcium, magnesium and phosphate levels, should be obtained. A toxicology screen should also be obtained to assess for illicit drugs as the cause of the VT, as well as levels of medications that may have caused the VT.

Laboratory Findings

• Ionized calcium levels along with magnesium and phosphate levels should be obtained.

• Hypocalcemia, hypokalemia, and hypomagnesemia make patients vulnerable to monomorphic VT or torsade de pointes.
• Diuretic usage can lead to hypokalemia which can provoke ventricular tachycardia.

• Cardiac troponin I and cardiac troponin T levels along with CK-MB and LDH can help access myocardial ischemia or infarction.

• Digoxin and tricyclic antidepressant blood levels should be ordered.

• Sometimes recreational drugs like cocaine, can result in ventricular tachycardia so a toxicology screen should also be obtained.

Laboratory Pearls for Ventricular Tachycardia
Electrolytes	Hypokalemia and hypomagnesemia frequently associated with torsades de pointes
Troponin I	Elevated in myocardial infarction
Creatine-kinase MB	Elevated in myocardial infarction