Del Rosario Marc E, Weachter Richard, Flaker Greg C
University of Missouri Hospital and Clinics, Division of Cardiovascular Medicine, USA.
Mo Med. 2010 Jan-Feb;107(1):53-8.
Prolongation of the QT interval can predispose to a potentially fatal polymorphic ventricular tachycardia called torsades de pointes (TdP). Although usually self-limited, TdP may degenerate into ventricular fibrillation and cause sudden death. Some medications that cause QT prolongation and possible TdP are commonly used in general practice. This paper presents a case of sudden death that is likely from drug-induced TdP. It reviews the mechanisms, risk factors, offending agents, and management of drug-induced torsades de pointes.
QT间期延长可诱发一种潜在致命的多形性室性心动过速,称为尖端扭转型室速(TdP)。虽然TdP通常为自限性,但可能恶化为心室颤动并导致猝死。一些可引起QT间期延长及可能导致TdP的药物在普通临床实践中常用。本文介绍了一例可能由药物诱发TdP导致的猝死病例。文中回顾了药物诱发尖端扭转型室速的机制、危险因素、致病药物及处理方法。