Bruggisser M, Rätz Bravo A, Bodmer M
Abteilung für Klinische Pharmakologie und Toxikologie und Regionales Pharmakovigilance Zentrum Basel.
Praxis (Bern 1994). 2009 Dec 2;98(24):1409-15; quiz 1415. doi: 10.1024/1661-8157.98.24.1409.
We report on a 76 year old woman who fainted on her way to the restroom during the night. At the emergency department, a prolonged QT-interval was noticed in addition to sinusbradycardia and marginal hypokalemia. The QT-interval normalized promptly after citalopram was discontinued. Taking into account the clinical picture and the ascertained orthostatic dysregulation, a diagnosis of orthostatic syncope was made. Because of the lengthened QT-interval, drug-induced torsade de pointes ventricular arrhythmia was considered as a differential diagnosis. We describe that citalopram was most probably the cause for the prolonged QT-interval. In our article we discuss the pathophysiology of drug-induced long QT syndrome (LQTS), the most important drugs involved, and finally the prophylaxis and treatment of a TdP ventricular arrhythmia.
我们报告了一名76岁女性，她夜间在去洗手间的路上晕倒。在急诊科，除窦性心动过缓和边缘性低钾血症外，还发现QT间期延长。停用西酞普兰后，QT间期迅速恢复正常。综合临床表现及已确定的体位性调节障碍，诊断为体位性晕厥。由于QT间期延长，药物性尖端扭转型室性心律失常被列为鉴别诊断。我们描述西酞普兰很可能是QT间期延长的原因。在我们的文章中，我们讨论了药物性长QT综合征（LQTS）的病理生理学、涉及的最重要药物，以及最后尖端扭转型室性心律失常的预防和治疗。
