Cesium toxicity from alternative cancer therapies should be considered in the differential diagnosis of prolonged QT interval and polymorphic ventricular tachycardia.
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Consider cesium toxicity in unexplained QT prolongation with polymorphic VT; case reports leave open incidence and risk factors.
Cesium salts have been used in animal models to induce cardiac arrhythmias for several decades, but the sequelae of human cesium toxicity have seldom been described. The authors describe a case of cesium toxicity manifested by syncope, polymorphic ventricular tachycardia, hypokalemia, and a QT interval prolonged to 650 milliseconds that resolved over 4 days following withdrawal of cesium. The patient had a 2-year history of colon cancer and had self-treated with cesium chloride, 3 g/d, for several weeks, using cesium as a form of alternate therapy for cancer. The authors describe the pathophysiologic correlates and risks of cesium consumption and conclude that cesium toxicity should be considered among the differential diagnoses of prolonged QT interval.
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Lyon et al. (2003) studied this question.
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