McGill Case 318

This case report is kindly provided by Michael Rosengarten from McGill and is part of the McGill Cases. These cases come from the McGill EKG World Encyclopedia. Previous Case: McGill Case 317 | Next Case: McGill Case 319

A 45 year old lady with palpitations and history of chronic renal failure Polymorphous ventricular tachycardia (Torsade de pointes). This is a form of VT where there is usually no difficulty in recognising its ventricular origin. wide QRS complexes with multiple morphologies changing R - R intervals the axis seems to twist about the isoelectric line it is important to recognise this pattern as there are a number of reversible causes heart block hypokalaemia or hypomagnesaemia drugs (e.g. tricyclic antidepressant overdose) congenital long QT syndromes other causes of long QT (e.g. IHD) This recording has been kindly donated by Dr G. Butrous of St George's Medical School London who is a cardiologist involved in EUROTOP. with permision from the site of Dr. Dean Jenkins