Motoyasu M, Nishikawa H, Shimizu Y, Aoki T, Ono N, Unno M, Kakuta Y, Yazu T, Kasai A, Yamakado T
Division of Cardiology, Yamada Red Cross Hospital.
Kokyu To Junkan. 1992 Feb;40(2):195-8.
A case was presented in which a rare T wave alternans occurred in association with congenital long QT syndrome. A 71-year-old woman, who had experienced several syncopal attacks per year for the previous forty years, was admitted for further evaluation of the syncope. She had a family history of sudden death (sister) and QT prolongation (son). Electrocardiogram showed a corrected QT interval of 0.68 seconds. Treadmill exercise-tolerance test revealed both T wave alternans immediately after exercise and torsades de pointes 150 seconds after exercise. The syncope was induced by the mental excitation. A prolonged corrected QT interval reduced from 0.70 seconds to 0.58 seconds by the correction of her serum potassium and magnesium. The effect of propranolol, verapamil, phenytoin or mexiletine on T wave alternans and ventricular arrhythmia was evaluated by the treadmill exercise-tolerance test. The treatment with propranolol was most effective.
报告了一例与先天性长QT综合征相关的罕见T波交替现象。一名71岁女性，在过去40年中每年经历几次晕厥发作，因晕厥进一步评估入院。她有猝死家族史（姐姐）和QT延长家族史（儿子）。心电图显示校正QT间期为0.68秒。平板运动耐量试验显示运动后立即出现T波交替，运动后150秒出现尖端扭转型室速。晕厥由精神兴奋诱发。通过纠正血清钾和镁，校正QT间期从0.70秒延长缩短至0.58秒。通过平板运动耐量试验评估了普萘洛尔、维拉帕米、苯妥英或美西律对T波交替和室性心律失常的影响。普萘洛尔治疗最有效。
