scholarly journals QT Prolongation and Associated Ventricular Tachycardia due to Cardiac Iron Load in a Patient with Thalassemia Major

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Derya Demirtas ◽  
Abdullah Orhan Demirtas ◽  
Hilmi Erdem Sumbul ◽  
Ayse Selcan Koc
Keyword(s):  
Ventricular Tachycardia ◽  
Qt Interval ◽  
Thalassemia Major ◽  
Qt Prolongation ◽  
High Dose ◽  
Resonance Imaging ◽  
Long Qt ◽  
Blocker Therapy ◽  
Iron Load ◽  
Magnetic Resonance Imaging Mri

We report the case of a 23-year-old male with thalassemia major who developed long QT and continuous ventricular tachycardia (VT). Electrocardiography, echocardiography, and cardiac magnetic resonance imaging (MRI) were used for diagnosis and risk stratification. VT causes and treatments are presented and discussed. Ventricular arrhythmia can be treated by normalizing QT interval with high-dose beta-blocker therapy. However, MRI-compatible internal cardiac defibrillator implantation was performed due to the high risk in this patient.

scholarly journals Acquired Long QT Interval: A Case Series of Multifactorial QT Prolongation

2011 ◽  
Vol 34 (9) ◽  
pp. 577-582 ◽  
Author(s):  
Geneviève C. Digby ◽  
Andrés Ricardo Pérez Riera ◽  
Raimundo Barbosa Barros ◽  
Christopher S. Simpson ◽  
Damian P. Redfearn ◽  
...  
Keyword(s):  
Qt Interval ◽  
Case Series ◽  
Qt Prolongation ◽  
Long Qt ◽  
Long Qt Interval

Impact of magnetic resonance imaging (MRI) in the local staging, risk group classification, and treatment of patients with prostate cancer with combination of high dose rate (HDR) brachytherapy and external beam radiotherapy (EBRT).

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 202-202
Author(s):  
Alfonso Gomez-Iturriaga ◽  
Francisco Casquero ◽  
Claudia Carvajal ◽  
Arantxa Urresola ◽  
Begona Canteli ◽  
...  
Keyword(s):  
Risk Group ◽  
External Beam Radiotherapy ◽  
High Dose Rate ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Resonance Imaging ◽  
Mri Staging ◽  
Local Staging ◽  
Magnetic Resonance Imaging Mri ◽  
Classification And Treatment

202 Background: To assess the impact of magnetic resonance imaging (MRI) staging for patients undergoing High Dose Rate (HDR) brachytherapy with external beam radiotherapy (EBRT). Methods: Fifty consecutive patients with intermediate risk and high risk prostate cancer underwent staging MRI. The MRI findings were used to guide stage-appropriate treatment recommendations, and to assist in the preplanning and optimization of the brachytherapy isodose distributions. Results: Median age of the patients was 71 years (range 58-78), median pre-treatment PSA was 10.15 ng/ml (3.3-66), median prostate volume was 35cc (14-58). Eighty-four percent of the patients were Gleason ≥ 7. Fifty-two percent had ≥ 50 of cores involved. Fifty four percent of patient’s PSA was ≥ 10 ng/ml. Pre-MRI staging was T1 in 70% of the patients, T2 in 30 %. Of the 50 patients staged by MRI, 70% were upstaged from the digital rectal examination-based clinical stage; 46% of cT1- T2 patients were upstaged to cT3. This upstaging changed the risk group in 56% of the patients while using the NCCN classification and in 24% when the D’Amico classification was used. The treatment reccomendation was modified in 26% and 20% of the patients using the NCCN and the D’Amico classification respectively. Conclusions: Staging MRI impacts in the assessment of the local staging, leading to changes in risk group classification and treatment decision in intermediate and high risk patients undergoing HDR brachytherapy and EBRT.

scholarly journals QT-prolongation and noncompaction

2019 ◽  
pp. 01-03
Author(s):  
Josef Finsterer ◽  
Claudia Stöllberger
Keyword(s):  
Ventricular Fibrillation ◽  
Long Qt Syndrome ◽  
Qt Interval ◽  
Genetic Defect ◽  
Neuromuscular Disorder ◽  
Left Ventricular ◽  
Qt Prolongation ◽  
Long Qt ◽  
Qt Syndrome

In a recent article, Szulik et al. reported about a 22 years old female with ventricular fibrillation, QT-prolongation, and left ventricular hypertrabeculation/noncompaction (LVHT) who died from hypoxic cerebral damage 5 days after admission [1]. We have the following comments and concerns. Patients with LVHT have a disposition for any type of cardiac arrhythmia [2,3]. This is why ventricular fibrillation not only could be due to hereditary long-QT syndrome but also due to LVHT. Ventricular fibrillation was either due to LVHT or a consequence of QT-prolongation. QT-prolongation is not unusual in LVHT and has been reported in several cases (table 1) [3-7]. LVHT has been also reported in association with long-QT-syndrome due to mutations in the KCNQ1 gene [8], in the KCNH2 gene [9], or due to an unidentified genetic defect (table 1) [10]. In a study of 105 patients with LVHT, the QT-interval increased during a mean follow up of 3.6y in 15 patients and normalized in 21 patients [11]. The increase was associated with the extension of LVHT and the presence of a neuromuscular disorder (NMD) [11].

scholarly journals PARP inhibitor-induced torsades de pointes in long QT syndrome: a case report

2019 ◽  
Vol 4 (1) ◽  
pp. 1-5
Author(s):  
Louise Segan ◽  
Ashley Beekman ◽  
Shane Parfrey ◽  
Mark Perrin
Keyword(s):  
Qt Interval ◽  
Parp Inhibitor ◽  
Torsades De Pointes ◽  
Parp Inhibitors ◽  
Qt Prolongation ◽  
Long Qt ◽  
Brca Mutations ◽  
Case Summary ◽  
Dose Dependent Increase ◽  
Dose Dependent

Abstract Background Poly ADP-ribose polymerase (PARP) inhibitors target pathogenic BRCA mutations in chemotherapy-resistant malignancies. PARP inhibitors cause modest dose-dependent QT prolongation in the setting of a normal baseline QT interval. Case summary We describe a case of PARP inhibitor-induced torsades de pointes (TdP) in an 86-year-old gentleman prescribed rucaparib due to chemotherapy-resistant, metastatic prostate cancer with pre-existing long QT, with an apparent dose-dependent increase in QT interval. The patient presented with syncope and recurrent TdP requiring direct cardioversion reversion (200 J biphasic) and an isoprenaline infusion (2 μg/min). There were no other QT prolonging agents and no electrolyte or metabolic disturbance to account for this arrhythmia. Improvement in QT interval was observed within 72 h of rucaparib cessation. Discussion PARP inhibitors cause a modest, dose-dependent increase in QT interval in patients with a normal baseline. The safety of PARP inhibitors in patients with pre-existing long QT has not been evaluated. This is the first reported case of rucaparib-associated TdP in a patient with pre-existing long QT, highlighting the amplified effect of this agent in individuals with pre-existing QT prolongation and the risk of fatal arrhythmias.

Medicolegal Problems in the Management of Cardiac Arrhythmias in Children

PEDIATRICS ◽  
1987 ◽  
Vol 79 (1) ◽  
pp. 84-88
Author(s):  
Arthur Garson
Keyword(s):  
Ventricular Tachycardia ◽  
Sudden Death ◽  
Cardiac Arrhythmias ◽  
Qt Interval ◽  
Long Qt ◽  
Seizure Disorders ◽  
Long Qt Interval ◽  
Potential Problems ◽  
Optimal Medical Management ◽  
Medicolegal Problems

Malpractice actions against pediatricians treating patients with arrhythmias have been recurrent in four general areas. Optimal medical management may not be widely recognized. Cases illustrating the following concepts are presented. (1) Intravenous verapamil therapy in babies may cause apnea, hypotension, and bradycardia; (2) continued episodes of atrial flutter in a child may cause sudden death; quinidine may be related to the death; (3) children with "familial seizure disorders" may in fact have the long QT interval syndrome. The QT interval must be measured on the ECG in patients with unexplained seizures; (4) "supraventricular tachycardia with aberration" is uncommon in children. Rapid heart rates with QRS complexes that are different from the sinus complexes are likely to be ventricular tachycardia. These situations must be recognized as potential problems and must be treated appropriately.

ICHD-II Diagnostic Criteria for Tolosa—Hunt Syndrome in Idiopathic Inflammatory Syndromes of the Orbit and/or the Cavernous Sinus

Cephalalgia ◽  
2008 ◽  
Vol 28 (6) ◽  
pp. 577-584 ◽  
Author(s):  
S Colnaghi ◽  
M Versino ◽  
E Marchioni ◽  
A Pichiecchio ◽  
S Bastianello ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Response To Treatment ◽  
High Dose ◽  
Inclusion Criteria ◽  
Resonance Imaging ◽  
Hunt Syndrome ◽  
Magnetic Resonance Imaging Mri

A bibliographical search was conducted for papers published between 1999 and 2007 to verify the validity of International Classification of Headache Disorders (ICHD)-II criteria for the Tolosa-Hunt syndrome (THS) in terms of (i) the role of magnetic resonance imaging (MRI); (ii) which steroid treatment should be considered as adequate; and (iii) the response to treatment. Of 536 articles, 48, reporting on 62 patients, met the inclusion criteria. MRI was positive in 92.1% of the cases and it normalized after clinical resolution. There was no evidence of which steroid schedule should be considered as adequate; high-dose steroids are likely to be more effective both to induce resolution and to avoid recurrences. Pain subsided within the time limit required by the ICHD-II criteria, but signs did not. We conclude that THS diagnostic criteria can be improved on the basis of currently available data. MRI should play a pivotal role both to diagnose and to follow-up THS.

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