A 34-year-old woman on sotalol for atrial fibrillation presents with sudden syncope. Vital signs show BP 88/56 mmHg, HR 160 bpm, RR 22/min, and SpO2 94% on room air. Telemetry reveals polymorphic ventricular tachycardia with QRS complexes twisting around the isoelectric baseline. ECG shows a prolonged QTc interval of 520 ms. She denies palpitations prior to syncope and has no family history of sudden cardiac death. Serum potassium is 3.2 mEq/L. Which diagnosis best explains these findings?
- A)AV nodal reentrant tachycardia
- B)Cardiogenic shock
- C)Atrial flutter
- D)Torsades de pointesGABARITO
- E)Wolff Parkinson White syndrome
Explicação
Torsades de pointes is correct. Polymorphic ventricular tachycardia in the setting of QT prolongation is the defining pattern of torsades. Common triggers include antiarrhythmics, macrolides, antipsychotics, low magnesium, and congenital long QT syndromes. Ver explicação completa e trilha adaptativa →