User:Mr. Ibrahem/Torsades de pointes
| Torsades de pointes | |
|---|---|
| Other names | Torsade de pointes, torsades |
 | |
| 12-lead ECG of torsades de pointes (TdP) in a person with low blood potassium (2.4 mmol/L) and low blood magnesium (1.6 mg/dL) | |
| Pronunciation |
|
| Specialty | Cardiology |
| Symptoms | None, palpitations, lightheadedness, syncope[1] |
| Complications | Ventricular fibrillation, sudden cardiac death[1] |
| Risk factors | QT prolongation, low potassium, low magnesium, low calcium, low heart rate, heart disease[1] |
| Diagnostic method | electrocardiogram (ECG)[1] |
| Differential diagnosis | Ventricular tachycardia, ventricular fibrillation[1] |
| Prevention | Stopping certain medications, correcting electrolytes[1] |
| Treatment | Intravenous magnesium, electrical cardioversion, defibrillation[1] |
| Frequency | Rare[1] |
Torsades de pointes (TdP) is a specific type of abnormal heart rhythm.[1] In about half of cases there are no symptoms while many of the rest have palpitations, lightheadedness, or syncope.[1] In up to 10% of cases there is ventricular fibrillation and sudden cardiac death.[1]
Risk factors include QT prolongation, low potassium, low magnesium, low calcium, low heart rate, and heart disease.[1] QT prolongation can be either inherited or occur from medication such as antiarrhythmics, antipsychotics, antiemetics, antifungals, or antibiotics.[1] Genetic conditions that cause QT prolongation include Jervell and Lange-Nielsen syndrome and Romano-Ward syndrome.[1] Diagnosis is by an electrocardiogram (ECG) showing polymorphic ventricular tachycardia with gradually changing height of the QRS complexes.[1]
Prevention involves avoiding medications that result in QT prolongation and correcting electrolytes.[1] Many episodes end without any specific treatment.[1] Intravenous magnesium at a dose of 2 grams injected slowly into a vein is often recommended.[1] In those with low blood pressure but a pulse electrical cardioversion at 50 to 100J is recommended.[1] If no pulse is present defibrillation is recommended.[1] Other options may include isoproterenol or overdrive pacing to speed up the heart rate.[1]
TdP is rare.[1] About 1 in a million people are estimated to get TdP due to medications a year in Europe.[1] Women are more often affected than men as are those over the age of 65.[1] It was described by French physician François Dessertenne in 1966.[2][3] The term is from the French "twisting of points".[3]
References[edit]
- ^ a b c d e f g h i j k l m n o p q r s t u v w x Cohagan, B; Brandis, D (January 2020). "Torsade de Pointes". PMID 29083738.
{{cite journal}}: Cite journal requires|journal=(help) - ^ Dessertenne, F. (1966). "La tachycardie ventriculaire a deux foyers opposes variables". Archives des maladies du coeur et des vaisseaux (in French). 59 (2). Prepared by Rahel Farhad: 263–272. ISSN 0003-9683. PMID 4956181.
- ^ a b Starr, Anthony B.; Jayasena, Hiruni; Shantikumar, Saran; Capewell, David (2016). Get ahead! Medicine: 150 EMQs for Finals, Second Edition. CRC Press. p. 275. ISBN 978-1-4987-3908-5. Archived from the original on 2021-08-29. Retrieved 2021-02-09.