Sudden Cardiac Death in a Dialysis Patient: Hyperkalemia Reconsidered

Martindale, Jennifer L.; Aherne, Andrew; Sinert, Richard

doi:10.1016/j.jemermed.2014.04.025

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“…There are numerous risk factors for the acquired form of LQTS, with novel causes being reported each year. 17 , 18 , 19 However, what distinguished this case were the recurrences of TdP during somnolence. While previous studies have suggested a theoretical mechanism for TdP during sleep, we are not aware of any cases in the literature.…”

Section: Discussionmentioning

confidence: 75%

Sleep-Associated Torsades de Pointes: A Case Report

Carmelli¹,

deSouza²

2017

CPCEM

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Torsades de Pointes (TdP) is a polymorphic ventricular tachycardia that occurs in the presence of an acquired or congenital long QT syndrome (LQTS). We present the case of a 57 year-old man with end-stage renal disease on methadone maintenance in which there occurred multiple episodes of TdP during sleep. The patient was found to have a QTc interval of 548 milliseconds, and the dysrhythmia was successfully treated with isoproterenol infusion and methadone substitution. It is surmised that the patient had a multifactorial, acquired LQTS that during somnolence, reached a critical threshold of QT prolongation to lead to the development of TdP.

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Section: Discussionmentioning

confidence: 75%