Key result
Severe electrolyte abnormalities in cirrhosis linked to acquired LQTS, macroscopic T-wave alternans, and polymorphic VT.
Case Report (n=1)
Macroscopic T-wave alternans is a critical electrocardiographic warning sign for life-threatening arrhythmias that necessitates immediate intervention with intravenous magnesium sulfate.
MTWA may flag acute arrhythmia risk warranting prompt evaluation; leaves open its value for routine monitoring or risk stratification.
T-wave alternans (TWA), also known as repolarization alterations, refers to the alternating pattern observed in the ST segment, T wave, and U wave. Macroscopic TWA (MTWA) has been observed in patients with various conditions, such as ischemia, electrolyte imbalances, long QT syndrome, and transitions from tachycardia to a normal rhythm. Its recognition is of utmost importance as it serves as a red flag for potentially life-threatening cardiac arrhythmias. Prompt treatment is crucial in order to prevent cardiac arrest and its complications. Patients who exhibit MTWA should be promptly treated with intravenous magnesium sulfate, as magnesium deficiency can contribute to arrhythmias. Additionally, efforts should be made to identify and address any reversible causes that may be contributing to the MTWA. Timely intervention is key to achieving the best possible outcome for patients with MTWA.
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Soodi et al. (2025) conducted a case report in Macroscopic T-Wave Alternans and Cirrhosis (n=1). Electrolyte abnormalities and cirrhosis was evaluated. A 32-year-old male with cirrhosis and severe electrolyte abnormalities developed macroscopic T-wave alternans and polymorphic ventricular tachycardia, emphasizing the risk of acquired long QT syndrome in end-stage liver disease.
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