Key result
IV magnesium and spironolactone resolve recurrent TdP and syncope in acquired LQTS with AV block.
Case Report (n=1)
No
Prompt recognition and electrolyte modulation are critical in managing Torsades de Pointes associated with acquired long QT syndrome to prevent sudden cardiac death.
Alerts clinicians to TdP risk in 2:1 AV block with prolonged QT; hypothesis-generating and should not yet change practice.
(TdP, meaning "twisting of the points") is a polymorphic ventricular tachycardia (VT) characterized by twisting QRS complexes around the isoelectric line, typically associated with prolonged QT intervals from congenital or acquired causes. A 64-year-old woman with hypertension presented with recurrent syncope and bradycardia. A 12-lead electrocardiogram (ECG) revealed a 2:1 atrioventricular block (AVB) and a prolonged corrected QT (cQT) interval (544 ms). Holter monitoring showed repeated episodes of TdP correlating with her symptoms. This case underscores prompt recognition and treatment to prevent sudden cardiac death - in this case, by electrolyte modulation.
No takes yet. Share an insight, caveat, or question.
Dzebu et al. (2025) conducted a case report in Acquired Long QT Syndrome with Torsades de Pointes (n=1). Magnesium sulfate and spironolactone was evaluated on Resolution of Torsades de Pointes and syncope. Intravenous magnesium sulfate followed by oral spironolactone successfully resolved recurrent syncope and Torsades de Pointes in a 64-year-old woman with acquired long QT syndrome and 2:1 atrioventricular block.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: