Long QT Interval Post-VF

Report:

Sinus rhythm 65/min

Right axis deviation +100o

Late transition

Long QT interval 0.54”

QTc 0.56”

Nonspecific ST/T changes

Comment:

She died from cerebral sequelae of her VF arrest; it is reasonable to ascribe the QT prolongation to cerebral injury. She was also on sotalol, which is the likely cause of the original QT prolongation resulting in torsade de pointes and VF. Autopsy revealed yet another cause: a large circumferential subendocardial infarction, most likely due to the arrest and prolonged resuscitation that followed (the coronary tree was normal). The infarction may account for much of the voltage loss seen in the next trace (31a).

The cause of the progressive RAD remains unknown, but probably involves her infarction.

31a. The QT interval has normalised, but that was the only good news. She became brain-dead soon after this trace was recorded. 32. Asymptomatic 24 year old lady in Casualty following an episode of palpitations

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