Repeated ventricular.

Area of Science:

• Cardiology
• Endocrinology

Background:

• Hypothyroidism is rarely associated with life-threatening arrhythmias like torsades de pointes (TdP) and ventricular fibrillation.
• Acquired long QT syndrome can develop in patients with hypothyroidism, increasing arrhythmia risk.

Purpose of the Study:

• To report a case of TdP and ventricular tachycardia in a patient with hypothyroidism and prolonged QT syndrome.
• To highlight the effectiveness of ventricular electrostimulation in managing these arrhythmias.

Main Methods:

• Case presentation of a 51-year-old woman with Hashimoto disease and hypothyroidism.
• Diagnosis of hypometabolic crisis, shock, sinus bradycardia, and QT interval prolongation (0.8 s).
• Treatment with ventricular electrostimulation due to ineffective pharmacological management.

Main Results:

• The patient experienced paroxysmal TdP ventricular tachycardia triggered by R-on-T extrasystoles.
• Ventricular stimulation at 90/min shortened the QT interval, resolved the arrhythmia, and improved cardiogenic shock.
• Successful L-thyroxine therapy normalized QTc to 0.43 s, with no recurrence during follow-up.

Conclusions:

• Hypothyroidism is a potential cause of acquired long QT syndrome and severe cardiac arrhythmias.
• Ventricular electrostimulation can be a life-saving intervention for arrhythmias complicating hypometabolic crisis in hypothyroid patients.