User:Mr. Ibrahem/Torsades de pointes

Torsades de pointes (TdP) is a specific type of abnormal heart rhythm. In about half of cases there are no symptoms while many of the rest have palpitations, lightheadedness, or syncope. In up to 10% of cases there is ventricular fibrillation and sudden cardiac death.

Risk factors include QT prolongation, low potassium, low magnesium, low calcium, low heart rate, and heart disease. QT prolongation can be either inherited or occur from medication such as antiarrhythmics, antipsychotics, antiemetics, antifungals, or antibiotics. Genetic conditions that cause QT prolongation include Jervell and Lange-Nielsen syndrome and Romano-Ward syndrome. Diagnosis is by an electrocardiogram (ECG) showing polymorphic ventricular tachycardia with gradually changing height of the QRS complexes.

Prevention involves avoiding medications that result in QT prolongation and correcting electrolytes. Many episodes end without any specific treatment. Intravenous magnesium at a dose of 2 grams injected slowly into a vein is often recommended. In those with low blood pressure but a pulse electrical cardioversion at 50 to 100J is recommended. If no pulse is present defibrillation is recommended. Other options may include isoproterenol or overdrive pacing to speed up the heart rate.

TdP is rare. About 1 in a million people are estimated to get TdP due to medications a year in Europe. Women are more often affected than men as are those over the age of 65. It was described by French physician François Dessertenne in 1966. The term is from the French "twisting of points".