Ann Intern Med. 1995;122(9): doi: / Figure Legend:

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From: Electrophysiologic Mechanisms of the Long QT Interval Syndromes and Torsade de Pointes Ann Intern Med. 1995;122(9):701-714. doi:10.7326/0003-4819-122-9-199505010-00009 Figure Legend: Example of extreme prolongation of the QT interval in a 21-year-old woman with the hereditary long QT interval syndrome (the Romano-Ward syndrome).This 12-lead electrocardiogram was obtained 48 hours after the patient had a cardiac arrest. The patient had a long history of exertion-related syncope, probably due to recurrent episodes of adrenergic-dependent torsade de pointes. The QT segment was bizarrely inverted in all leads and measured 520 ms even though the RR interval was only 630 ms. Because of the dramatic T-wave changes, the patient was initially misdiagnosed with myocardial ischemia, but a coronary arteriogram and a left ventricular angiogram were normal. She was successfully treated with β-adrenergic blockade and overdrive permanent pacing. Date of download: 3/2/2018 Copyright © American College of Physicians. All rights reserved.