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ECG Corner

Answers to the current quiz:

This lady had congenital Long QT syndrome which predisposes her to develop Torsades de Pointes. (VT) Other factors that could have increased her QT interval include electrolyte imbalances (being on a diuretic), Macrolide Antibiotics and Ischemia.

There are may causes of QT prolongation, but to have a few in your mind think of the pneumonic

Big DICE

Bradycardia
i
g
Drugs
Ischemia / Injury - Head. This could result in raised intracranial pressure.
Congenital
Electrolyte imbalances (Hypo …Potassium, Calcium, Magnesium) … remember that by recalling a dice always falls down 😉

This patients QT/ QTc (corrected)  interval was 600/ 667 msec. QT (corrected)  is considered long if it is greater than 450 sec in males and 470 sec in females.

Her management would include treating the reversible causes (electrolyte imbalances, ischemia, stopping the offending drugs) and referral to an Electrophysiologist for further management. This may include insertion of a Defibrillator.