Torsade de pointes

Torsade de pointes
DiseasesDB	29252
MeSH	D016171

Torsades de pointes Microchapters
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Differentiating Torsades de pointes from other Diseases
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EKG Examples
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Clinical Correlation

1. Drugs: quinidine, PCA, norpace, amiodarone, phenothiazines, Tricyclic antidepressants, pentamidine.
   • with quinidine majority of the cases occur within one week of initiation, and with therapeutic levels
2. Electrolyte imbalances: Hypokalemia, hypomagnesemia, hypocalcemia
3. CAD
4. MVP
5. Variant angina
6. Myocarditis
7. Subarachnoid hemorrhage
8. Congenital QT prolongation
9. Liquid protein diets
10. Hypothyroidism
    • because of bradycardia and a prolonged QT syndrome
11. Organophosphate poisoning

Other lab studies

• Electrolytes levels to rule out hypokalemia, hypomagnesemia, and hypocalcemia.
• Cardiac enzymes
• Echocardiography to rule out structural heart disease

Additional Information

• Torsade de Pointes and Polymorphic VT

Examples

EKG's shown below are courtesy of C. Michael Gibson MS MD, and copylefted

• 
  12 lead EKG at admission
• File:TdP.1.2.1.jpg
• File:TdP.1.2.2.jpg
• File:TdP.1.3.1.jpg
• File:TdP.1.3.2.jpg
• File:TdP.1.4.1.jpg
• File:TdP.1.4.2.jpg
• File:TdP.1.5.1.jpg
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• 
• 
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Examples from different resources

• 
  Arrhythmias in a patient with short coupled torsade de pointes
• 
  Arrhythmias in a patient with short coupled torsades de pointes degenerating in ventricular fibrillation

• 
  Arrhythmias in a patient with short coupled torsade de pointes: frequent short coupled extrasystoles
• 
  Arrhythmias in a patient with short coupled torsade de pointes: frequent short coupled extrasystoles

• 
  A 12 lead ECG recording example of TdP

Characteristic tracing showing the "twisting" (blue line) of Torsade de pointes

References

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