Case 1
This ECG was texted to me last week with the question: "What is this??"
What do you think?
My answer: "This is a pre-torsades EKG. Watch out! Every other beat, a PVC, has an extremely long QT. In my experience, patients with ECGs like this are at very high risk of TORSADES. I have seen this several times."
Outcome
It came from a patient who had been falling much, had a K of 2.8, and is on methadone but taking too much. The patient then received K and Mg. Torsades did not ensue. The ECG findings resolved after metabolism of methadone and K replenishment.
See several similar cases below, all of which were recorded before, during, or after Torsades de Pointes.
Case 2. Polymorphic Ventricular Tachycardia
Torsades de Pointes
Case 3
Case 3, 8 minutes later
Case 3, later
Case 3, later
Case 3, later
Case 3, later
Case 3, later
Case 4, had Torsades after these ECGs
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