AI Article Synopsis
- An 85-year-old woman experienced several episodes of fainting and was found to have bradycardia and prolonged QT interval on her ECG, which led to torsades de pointes arrhythmia.
- Doctors discontinued potential problematic medications and treated her with magnesium and potassium, but she continued to have arrhythmias until an isoprenaline infusion was started, which improved her heart rate and stabilized her condition.
- Further tests revealed severe hypothyroidism as the underlying cause, leading to the initiation of levothyroxine treatment; however, she ultimately required a permanent pacemaker and was discharged without further issues.
Article Abstract
An 85-year-old lady presented to our institution following multiple episodes of transient loss of consciousness. Her admission ECG revealed a junctional bradycardia with significant QT prolongation. Telemetry captured a torsades de pointes arrhythmia. Possible offending drugs (digoxin and hydroxychloroquine) were stopped and she was given intravenous magnesium and potassium. Despite this, she continued to have runs of torsades. An isoprenaline infusion was commenced to increase her resting heart rate. Her QT interval shortened and she had no further arrhythmia. Investigation into the cause of her bradycardia and prolonged QT revealed profound hypothyroidism. Levothyroxine was commenced but the patient remained bradycardia and required a permanent pacemaker. She had no further arrhythmia and was discharged home safely. This is a very rare case of severe primary hypothyroidism presenting with torsades de pointes.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3534300 | PMC |
| http://dx.doi.org/10.1136/bcr.12.2011.5306 | DOI Listing |
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