Torsades de pointes history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History and Symptoms
Torsades is a rapid, polymorphic ventricular tachycardia with a characteristic twist of the QRS complex around the isoelectric baseline. It is also associated with a fall in arterial blood pressure, which gives rise to the syncopal symptoms experienced by patients. Although torsade de pointes is a rare ventricular arrhythmia, it can degenerate into ventricular fibrillation, which will lead to sudden death in the absence of medical intervention.
History
It is important to gather the following information from the patient:
- History of congenital long QT syndrome
- Family history of sudden cardiac death
- Family history of sudden infant death syndrome
- Family history of congenital deafness (Jervell and Lange-Nielsen syndrome presenting with congenital sensorineural deafness and cardiac abnormalities)
- Family history of congenital long QT syndrome with normal hearing i.e. Romano-Ward syndrome
- Medication history to rule out acquired causes of Torsade de pointes
Symptoms
- Nausea, vomiting
- Shortness of breath
- Chest pain
- Recurrent palpitations
- Dizziness
- Syncope
- Sudden cardiac death