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[Iatrogenic torsade de pointes induced by thioridazine]
P Paoloni1, D Ciliberti, N Blasi
1Servizio di Cardiologia, Ospedale Civile di Fermo Ascoli Piceno.
Minerva Cardioangiologica
|June 1, 1992
Summary
Torsade de pointes, a dangerous heart rhythm, can be effectively treated with magnesium and pacing. This case highlights successful management of drug-induced torsade de pointes.
Area of Science:
- Cardiology
- Clinical Electrophysiology
- Pharmacology
Background:
- Torsade de pointes (TdP) is a specific type of polymorphic ventricular tachycardia associated with QT interval prolongation.
- Acquired causes, including medications and metabolic disturbances, are common triggers for TdP.
- Standard antiarrhythmic drugs are often ineffective for TdP management.
Observation:
- This report details a case of TdP induced by thioridazine, an antipsychotic medication.
- The patient presented with characteristic ECG findings of TdP.
Findings:
- Treatment with magnesium sulfate and overdrive right ventricular pacing proved highly effective.
- Potassium and magnesium repletion are crucial for managing drug-induced TdP.
- While cardiac pacing is preferred, isoproterenol may serve as an initial treatment.
Implications:
- This case underscores the efficacy of magnesium and pacing in TdP management.
- It emphasizes the importance of considering drug-induced QT prolongation in TdP cases.
- Highlights the critical role of electrolyte correction in TdP treatment.