A 58-year-old woman with atrial fibrillation started on sotalol 2 days ago presents with recurrent syncope. Vital signs: BP 92/58, HR 52, RR 18, SpO2 98% on room air. ECG demonstrates QTc interval of 520 ms. Telemetry captures polymorphic ventricular tachycardia with the QRS axis twisting around the baseline. Serum potassium is 3.2 mEq/L. She denies chest pain. Which diagnosis best explains these findings?

  1. A)Brugada syndrome
  2. B)Torsades de pointesGABARITO
  3. C)Monomorphic ventricular tachycardia
  4. D)Multifocal atrial tachycardia
  5. E)Atrial flutter with variable block

Explicação

This patient has torsades de pointes, a polymorphic ventricular tachycardia associated with QT prolongation. Class III antiarrhythmics such as sotalol can prolong repolarization and trigger early afterdepolarizations that precipitate torsades. Ver explicação completa e trilha adaptativa →

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