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Case Report
Correcting the QTc and fixing torsade’s, what can’t steroids do!
1 Department of Internal Medicine, United Health Services Hospitals, Binghamton, NY, USA
2 Department of Internal Medicine, University of South Alabama, Health University Hospital, Mobile, AL, USA
3 St. Bernard’s Health Care System, Heart and Vascular, Jonesboro, AR, USA
4 Mosaic Lifecare at St. Joseph Cardiovascular Care, St. Joseph, MO, USA
5 Department of Cardiology, University of South Alabama, Health University Hospital, Mobile, AL, USA
Address correspondence to:
Yasir Ahmed
MD, Department of Internal Medicine, United Health Services Hospitals, Binghamton, NY,
USA
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Article ID: 101357Z01YA2022
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Ahmed Y, Rahman M, Rafique M, Ahmad S, Awan GM. Correcting the QTc and fixing torsade’s, what can’t steroids do! Int J Case Rep Images 2022;13(2):185–188.ABSTRACT
Introduction: Long QT syndrome (LQTS) is the congenital or acquired prolongation of the QT interval on an electrocardiogram (ECG). It is well-known that the QT interval is prolonged in adrenal insufficiency (AI) but rarely prolonged enough to cause Torsade de Pointes (TdP).
Case Report: Here we report a case of TdP and cardiac arrest in a patient with adrenal insufficiency. The patient had a return of spontaneous circulation after a successful cardiopulmonary resuscitation (CPR). Electrocardiograms persistently showed prolonged QT corrected for heart rate (QTc) prior to and at the time of cardiac arrest, some exceeding 600 milliseconds (ms). The QT interval improved significantly upon administration of steroids and the episodes of TdP resolved.
Conclusion: This case highlights the importance of recognizing adrenal insufficiency (AI) as a potentially reversible cause of prolonged QT and TdP.
Keywords: Adrenal insufficiency, Cardiac arrest, Torsade de Pointes
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Author Contributions
Yasir Ahmed - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Mustafeez ur Rahman - Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Muhammad Rafique - Conception of the work, Design of the work, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Sajjad Ahmad - Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Ghulam Mustafa Awan - Conception of the work, Design of the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Yasir Ahmed et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
