What does torsades de pointes mean in English?
What does torsades de pointes mean in English?
Torsades de pointes, torsade de pointes or torsades des pointes (TdP) (/tɔːˌsɑːd də ˈpwæ̃t/, French: [tɔʁsad də pwɛ̃t̪], translated as “twisting of peaks”) is a specific type of abnormal heart rhythm that can lead to sudden cardiac death.
What is a torsades in medical terms?
torsades de pointes [tor-sahd´ duh pwahnt] an atypical rapid ventricular tachycardia with periodic waxing and waning of amplitude of the QRS complexes on the electrocardiogram. It is usually drug related and may be either self-limiting or progressing to ventricular fibrillation.
What does torsade mean?
: a twisted cord or ribbon used especially as a hat ornament.
How do you identify Torsades de Pointes in ECG?
Diagnosis. Diagnosis is by ECG showing an undulating QRS axis, with the polarity of complexes shifting around the baseline (see figure Torsades de pointes ventricular tachycardia). ECG between episodes shows a long QT interval after correction for heart rate (QTc).
What does torsades feel like?
You may suddenly feel your heart beating faster than normal, even when you’re at rest. In some TdP episodes, you may feel light-headed and faint. In the most serious cases, TdP can cause cardiac arrest or sudden cardiac death. It’s also possible have an episode (or more than one) that resolves quickly.
What does torsades look like?
Torsades de pointes is a specific form of polymorphic ventricular tachycardia in patients with a long QT interval. It is characterized by rapid, irregular QRS complexes, which appear to be twisting around the electrocardiogram (ECG) baseline.
Do you defibrillate torsades?
Occasional patients will have recurrent episodes of torsades (“Torsades storm”). Each individual episode may be treated with magnesium or defibrillation, if needed (Treatment step #1 above). However, additional therapies are required to stop recurrence and end the storm.
Do you have a pulse with torsades?
Patients with torsade may be hypotensive, have a rapid pulse and have loss of consciousness.
Is torsades VT or VF?
Frequent PVCs with ‘R on T’ phenomenon trigger a run of polymorphic VT which subsequently begins degenerates into VF. QT interval is difficult to see because of artefact but appears slightly prolonged (QTc ~480ms), making this likely to be TdP.
How rare is Torsades de Pointes?
The prevalence of torsade de pointes is unknown. Torsade is a life-threatening arrhythmia and may present as sudden cardiac death in patients with structurally normal hearts. In the United States, 300,000 sudden cardiac deaths occur per year. Torsade probably accounts for fewer than 5%.
What do you give for torsades?
Treatment of torsade de pointes includes: isoproterenol infusion, cardiac pacing, and intravenous atropine. Intravenous magnesium sulfate, a relatively new mode of therapy for torsade de pointes, was proven to be extremely effective and is now regarded as the treatment of choice for this arrhythmia.
Why is magnesium used for torsades?
Magnesium is the drug of choice for suppressing early afterdepolarizations (EADs) and terminating the arrhythmia. Magnesium achieves this by decreasing the influx of calcium, thus lowering the amplitude of EADs. Magnesium can be given at 1-2 g IV initially in 30-60 seconds, which then can be repeated in 5-15 minutes.
Is magnesium used to treat torsades?
Abstract. Background: Administration of magnesium sulfate (MgSO4) is an effective and safe treatment for torsades de pointes (TdP) associated with acquired long QT syndrome (LQTS) in adults.
Can anxiety cause prolonged QT?
Conclusion. High anxiety is associated with increased QT dispersion, which may predispose to cardiac arrhythmias.
What medications can cause torsades?
Other drugs that prolong the QT interval and have been implicated in cases of torsade include phenothiazines, tricyclic antidepressants, lithium carbonate, ziprasidone, cisapride, highly active antiretroviral drugs, high-dose methadone, anthracycline chemotherapeutic agents (eg, doxorubicin, daunomycin), some …
What medication reverses torsades Depointes?
If torsades de pointes is found to have an underlying medical cause, this will be treated first….Treatment
- beta-adrenergic antagonists, such as propranolol.
- implantable cardioverter defibrillator in rare cases.
Who is at risk for torsades de pointes?
Risk factors for torsade include the following: Congenital long QT syndrome. Female gender. Acquired long QT syndrome (causes of which include medications and electrolyte disorders such as hypokalemia and hypomagnesemia)
What medications should be avoided with long QT syndrome?
Psychotropics/Antidepressants/ Anticonvulsants The antipsychotics (including Thioridazine, Haloperidol Mesoridazine, chlorpromazine), the antidepressants (including Maptiline, Amitriptyline, imiprmaine, fluoxetine, desipramine, paroxetine) and anticonvulsants Felbamate and Fosphenytoin are to be avoided.
What triggers long QT syndrome?
Long QT syndrome is usually caused by a faulty gene inherited from a parent. The abnormal gene affects the heart’s electrical activity. Certain medicines can also trigger long QT syndrome, including some types of: antibiotics. antihistamines.
Does long QT syndrome make you tired?
What happens if I develop Long QT syndrome? Even when an ECG shows a long QT interval, many people never have severe heart problems and are able to live a normal life. However, some people develop symptoms, such as fainting, dizziness, fatigue, and heart palpitations.
Do beta blockers shorten QT interval?
Beta-blockers shorten the QT interval at faster heart rates and lengthen the QT interval at slower heart rates in type 1 long QT syndrome.
What drugs shorten QT interval?
Beta blockers used to treat long QT syndrome include nadolol (Corgard) and propranolol (Inderal LA, InnoPran XL). Mexiletine. Taking this heart rhythm drug in combination with a beta blocker might help shorten the QT interval and reduce your risk of fainting, seizure or sudden death.
Why are beta blockers used for long QT?
Beta-blockers are drugs of choice for patients with LQTS. The protective effect of beta-blockers is related to their adrenergic blockade, which diminishes the risk of cardiac arrhythmias. They may also reduce the QT interval in some patients.
What causes short QT interval?
Short QT syndrome appears to have an autosomal dominant pattern of inheritance, which means one copy of the altered gene in each cell is sufficient to cause the disorder. Some affected individuals have a family history of short QT syndrome or related heart problems and sudden cardiac death.
How do I fix my QT interval?
Corrected QT interval (QTc) Fridericia formula: QTC = QT / RR. Framingham formula: QTC = QT + 0.154 (1 – RR) Hodges formula: QTC = QT + 1.75 (heart rate – 60)
Can QTc be too short?
Short QT syndrome (SQTS) is a rare, inheritable channelopathy of the heart characterised by abnormally short QT intervals on the electrocardiogram (ECG) and an increased propensity to develop atrial and ventricular tachyarrhythmias in the absence of structural heart disease.
How do you treat a short QT?
Conclusions: The ability of quinidine to prolong the QT interval has the potential to be an effective therapy for short QT patients. This is particularly important because these patients are at risk of sudden death from birth, and ICD implant is not feasible in very young children.
What is considered short QT interval?
Short QT interval QTc intervals < 330 ms in males or < 340 ms in females should be considered diagnostic of SQTS. QTc intervals < 360 ms in males or < 370 ms in females should only be considered diagnostic of SQTS when supported by symptoms or family history.
What is Familial Short QT syndrome?
Short QT syndrome (SQTS) is an extremely rare but life-threatening familial disorder characterized by an abnormally short QT interval on the electrocardiogram (ECG), indicating that the heart muscle takes less time than usual to recharge between beats.
What can change a QT interval?
There are many drugs that can prolong the QT interval, such as some antibiotics, antidysrhythmics, antihistamines, antifungals, and antipsychotics. Other categories of drugs that cause QT prolongation are some heart medications, cholesterol-lowering drugs, and diabetes medications.