Torsade de Pointes and Marked QT Prolongation in Association with Hypothyroidism

Brief Reports1 May 1987Torsade de Pointes and Marked QT Prolongation in Association with HypothyroidismANIL KUMAR, M.D., ANIL K. BHANDARI, M.D., SHAHBUDIN H. RAHIMTOOLA, M.B.ANIL KUMAR, M.D., ANIL K. BHANDARI, M.D., SHAHBUDIN H. RAHIMTOOLA, M.B.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-5-712 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSustained ventricular tachyarrhythmias occur infrequently in patients with hypothyroidism (1, 2). In all previous reports (3-8), the morphologic features of ventricular tachyarrhythmias were not well characterized, and precipitating factors might have resulted in the tachyarrhythmias without hypothyroidism. The occurrence of torsade de pointes caused by hypothyroidism has not been well documented. We report the case of a patient with severe hypothyroidism in whom torsade de pointes occurred in association with marked prolongation of the QT interval. In evaluating the QT interval, we also retrospectively reviewed the medical records of 14 consecutive patients with hypothyroidism to determine the frequency and magnitude...References1. DEGROOT L. Thyroid and the heart. Mayo Clin Proc. 1972;47:864-71. MedlineGoogle Scholar2. HANSEN J. Paroxysmal ventricular tachycardia associated with myxedema: a case report. Am Heart J. 1961;61:692-7. CrossrefMedlineGoogle Scholar3. WINAWERROSENCOHN SSH. Myxedema coma with ventricular tachycardia. Arch Int Med. 1963;111:159-62. CrossrefGoogle Scholar4. MARCUSON R. Ventricular fibrillation in myxedema heart disease with spontaneous reversion. Br Heart J. 1965;27:455-7. CrossrefMedlineGoogle Scholar5. MACAULAYSHEPHERD MR. Syncope in myxoedema due to transient ventricular fibrillation. Postgrad Med J. 1971;47:361-7. CrossrefMedlineGoogle Scholar6. LIMLIM CP. Recurrent ventricular tachycardia in hypothyroidism. Aust NZ J Med. 1976;6:68-70. CrossrefMedlineGoogle Scholar7. FREDLUNDOLSSON BS. Long QT interval and ventricular tachycardia of "torsade de pointe" type in hypothyroidism. Acta Med Scand. 1983;213:231-5. CrossrefMedlineGoogle Scholar8. BHANDARISCHEINMAN AM. The long-QT syndrome. Mod Concepts Cardiovasc Dis. 1985;54:45-9. Google Scholar9. DOUGLASSAMUEL AP. Analysis of electrocardiographic patterns in hypothyroid heart disease. NY State J Med. 1960;60:2227-35. MedlineGoogle Scholar10. SURAWICZMANGIARDI BM. Electrocardiogram in endocrine and metabolic disorders. In: RIOS JC, ed. Clinical Electrocardiographic Correlations. Philadelphia: F.A. Davis; 1977:243. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ANIL KUMAR, M.D.; ANIL K. BHANDARI, M.D.; SHAHBUDIN H. RAHIMTOOLA, M.B.Affiliations: Los Angeles County-University of Southern California Medical Center Los Angeles, California. 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