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Patient
73-year-old woman with ischemic cardiomyopathy, treated with erythromycin and antihistamine for a community-acquired pneumonia with diarrhea; hospitalization for 3 episodes of severe syncope;
Trace
Baseline sinus rhythm; "monstrous" QT pattern which can exceed one second; isolated ventricular extrasystoles or inducing a burst of irregular polymorphic wide QRS tachycardia with significant variations in amplitude and in the polarity of the QRS complexes; spontaneous termination;
Exergue
Various cardiovascular (antiarrhythmics) and non-cardiovascular (psychotropics, antibiotics, antihistamines, etc.) drug classes can induce prolongation of the QT interval which can contribute to the occurrence of a torsade de pointes.
This patient presented syncopes occurring in the setting of an extremely long QT interval induced by the coexistence of ischemic heart disease, limit serum potassium values (3.5 at entry) as a result of diarrhea and by a double drug intake contributing to the prolongation of the QT interval: a ma