User:Mr. Ibrahem/Torsades de pointes
Type of abnormal heart rhythm / From Wikipedia, the free encyclopedia
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]
Torsades de pointes | |
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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 |
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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] |
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]