1. From: Electrophysiologic Mechanisms of the Long QT Interval Syndromes and Torsade de Pointes
Ann Intern Med. 1995;122(9): doi: /
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.
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