Document Detail

Severe primary hypothyroidism presenting with torsades de pointes.
MedLine Citation:
PMID:  22987900     Owner:  NLM     Status:  MEDLINE    
An 85-year-old lady presented to our institution following multiple episodes of transient loss of consciousness. Her admission ECG revealed a junctional bradycardia with significant QT prolongation. Telemetry captured a torsades de pointes arrhythmia. Possible offending drugs (digoxin and hydroxychloroquine) were stopped and she was given intravenous magnesium and potassium. Despite this, she continued to have runs of torsades. An isoprenaline infusion was commenced to increase her resting heart rate. Her QT interval shortened and she had no further arrhythmia. Investigation into the cause of her bradycardia and prolonged QT revealed profound hypothyroidism. Levothyroxine was commenced but the patient remained bradycardia and required a permanent pacemaker. She had no further arrhythmia and was discharged home safely. This is a very rare case of severe primary hypothyroidism presenting with torsades de pointes.
Sri Raveen Kandan; Mrinal Saha
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2012-09-17
Journal Detail:
Title:  BMJ case reports     Volume:  2012     ISSN:  1757-790X     ISO Abbreviation:  BMJ Case Rep     Publication Date:  2012  
Date Detail:
Created Date:  2012-09-18     Completed Date:  2014-01-21     Revised Date:  2014-07-03    
Medline Journal Info:
Nlm Unique ID:  101526291     Medline TA:  BMJ Case Rep     Country:  England    
Other Details:
Languages:  eng     Pagination:  -     Citation Subset:  IM    
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MeSH Terms
Acute Disease
Aged, 80 and over
Diagnosis, Differential
Heart / physiopathology
Hypothyroidism / complications*,  diagnosis,  drug therapy
Thyroxine / therapeutic use
Torsades de Pointes / diagnosis,  etiology*,  physiopathology
Reg. No./Substance:

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