Franchin M, Frattini B, Luft A, Klein I, Tourtier JP. Cardiac arrest caused by torsades de pointes? Med Emergency, MJEMÂ 2015; 23:24-5.
Key words: torsade de pointes, pre-hospital, treatment
- Authors’ affiliation
Correspondent author: Benoit Frattini , MD, MSc
Emergency Medicine Department, Fire Brigade of Paris
1 place Jules Renard, 75017, Paris, France
dr.frattini@gmail.com
Franchin M, MD, Frattini B, MD, MSc, Luft A, MD, Klein I, MD, Tourtier JP, MD, PhD
Emergency Medicine Department, Fire Brigade of Paris, France
- Authors’ contribution
- Article history / info
- Conflict of interest statement
Category: Case report
Received: Apr. 15, 2015
Revised: May 06, 2015
Accepted: May 20, 2015
ABSTRACT
Torsade de pointes (TdP) are a rare cause of cardiac arrest with very specific management. We report the case of an 82 years old patient, suffering a syncopal episode by torsades de pointes initially considered as cardiorespiratory arrest. The first line therapy treatment is based on intravenous magnesium administration to correct the consistently prolonged QT interval. In case of persistence of torsades and bradycardia, it is followed by an acceleration of the heart rate by means of atropine, an electrosystolic pacing or isoproterenol. Cessation of all QT-prolonging drugs and correction of electrolyte disturbances (frequent hypokalemia) are also essential.