Torsade de pointes (TdP) is a life threatening cardiac arrhythmia that is typically associated with prolongation of the QT interval. A wide variety of nonantiarrthymic medications may trigger TdP in patients with prolonged QT interval, only a few reports have described an association between TdP and methadone. We report a case of TdP caused by a large dose of methadone in a patient with presumably normal QT interval at baseline prior to his presentation at the hospital.

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