Key result
Conservative management reverses macroscopic T wave alternans and normalizes QT in rheumatic heart disease.
Why the study?
The authors intended to present a rare electrocardiographic repolarization abnormality, macroscopic T wave alternans, and its reversal to normal T waves and QT interval.
Case Report (n=1)
Highlights a rare case of macroscopic T wave alternans following cardioversion for ventricular tachycardia in a patient with rheumatic heart disease, which resolved with conservative management.
Post-cardioversion giant T waves in rheumatic HF warrant monitoring; single-case report leaves open their prognostic value.
A BSTRACT A middle-aged lady in her late forties and a known case of rheumatic heart disease presented with acute decompensated heart failure. On admission, she was found to have atrial fibrillation with fast ventricular rate. She was initially managed with mechanical ventilation, diuretics, and parenteral amiodarone. During admission, she had two episodes of ventricular tachycardia at 12 h interval for which she was electro-cardioverted. Post-cardioversion, she developed giant and deep T waves with macroscopic T wave alternans which is a harbinger of further malignant arrhythmias. She was managed conservatively, and she responded well to the treatment. We intend to present this rare electrocardiographic repolarization abnormality and its reversal to normal T waves and QT interval as the patient improved.
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Kaur et al. (2025) conducted a case report in Rheumatic heart disease with macroscopic T wave alternans (n=1). Conservative management was evaluated. Conservative management of a patient with rheumatic heart disease and macroscopic T wave alternans led to clinical improvement and reversal to normal T waves and QT interval.
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