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QT Prolongation Complicated with Torsades de Pointes in Prosthetic Mitral Valve Endocarditis: A Case Report.

Tounsi A, Abid L, Akrout M, Hentati M, Kammoun S - Case Rep Med (2012)

Bottom Line: The clinical course and the long QTc interval with deep inverted T wave were completely normalized 4 weeks after.He continued on triple antibiotic therapy for 45 days with a good revolution.The clinical features and the possible mechanisms of QT prolongation (inflammation, infection) of this patient are discussed.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Department, Hedi Chaker University Hospital, Sfax 3029, Tunisia.

ABSTRACT
We present the case of a 49-year-old male patient with prosthetic mitral valve endocarditis associated with QT prolongation and torsades de pointes. He was asymptomatic until the end of January 2012, when he was admitted to our hospital emergency unit because of syncope, fever, and suspicion of endocarditis. Cardiologic evaluation was requested and the transthoracic (TTE) and transesophageal (TEE) echocardiograms revealed vegetations on the prosthetic mitral valve. All cultures were positive for methicillin-sensitive Staphylococcus aureus. The corrected QT (QTc) interval was markedly prolonged upon admission (QTc 540 ms). He experienced torsades de pointes (TdP) several times and he was recovered after bystander cardiopulmonary resuscitation. The clinical course and the long QTc interval with deep inverted T wave were completely normalized 4 weeks after. He continued on triple antibiotic therapy for 45 days with a good revolution. The clinical features and the possible mechanisms of QT prolongation (inflammation, infection) of this patient are discussed.

No MeSH data available.


Related in: MedlinePlus

The electrocardiogram showed atrial fibrillation. The QT interval was markedly prolonged.
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fig1: The electrocardiogram showed atrial fibrillation. The QT interval was markedly prolonged.

Mentions: On physical examination the patient had a fever of 38°C. His blood pressure was 105/70 mmHg. There were no signs of heart failure. He had no signs of splinter haemorrhages, skin nodules, enlarged lymph nodes, nor hepatosplenomegaly. The electrocardiogram showed atrial fibrillation. The QT interval was markedly prolonged (Figure 1). His blood chemistry on admission showed an elevated C-reactive protein (CRP). His leukocyte count on admission and throughout the hospital course was within the normal range. Serum potassium, magnesium, calcium, and thyroid function tests were within the normal range. He had no history of taking drugs that prolong the QT interval. Transthoracic echocardiography revealed a functioning prosthetic bileaflet mitral valve. The mean pressure gradient across the mitral valve was 5. The left atrium was enlarged (62 mm).


QT Prolongation Complicated with Torsades de Pointes in Prosthetic Mitral Valve Endocarditis: A Case Report.

Tounsi A, Abid L, Akrout M, Hentati M, Kammoun S - Case Rep Med (2012)

The electrocardiogram showed atrial fibrillation. The QT interval was markedly prolonged.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3472411&req=5

fig1: The electrocardiogram showed atrial fibrillation. The QT interval was markedly prolonged.
Mentions: On physical examination the patient had a fever of 38°C. His blood pressure was 105/70 mmHg. There were no signs of heart failure. He had no signs of splinter haemorrhages, skin nodules, enlarged lymph nodes, nor hepatosplenomegaly. The electrocardiogram showed atrial fibrillation. The QT interval was markedly prolonged (Figure 1). His blood chemistry on admission showed an elevated C-reactive protein (CRP). His leukocyte count on admission and throughout the hospital course was within the normal range. Serum potassium, magnesium, calcium, and thyroid function tests were within the normal range. He had no history of taking drugs that prolong the QT interval. Transthoracic echocardiography revealed a functioning prosthetic bileaflet mitral valve. The mean pressure gradient across the mitral valve was 5. The left atrium was enlarged (62 mm).

Bottom Line: The clinical course and the long QTc interval with deep inverted T wave were completely normalized 4 weeks after.He continued on triple antibiotic therapy for 45 days with a good revolution.The clinical features and the possible mechanisms of QT prolongation (inflammation, infection) of this patient are discussed.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Department, Hedi Chaker University Hospital, Sfax 3029, Tunisia.

ABSTRACT
We present the case of a 49-year-old male patient with prosthetic mitral valve endocarditis associated with QT prolongation and torsades de pointes. He was asymptomatic until the end of January 2012, when he was admitted to our hospital emergency unit because of syncope, fever, and suspicion of endocarditis. Cardiologic evaluation was requested and the transthoracic (TTE) and transesophageal (TEE) echocardiograms revealed vegetations on the prosthetic mitral valve. All cultures were positive for methicillin-sensitive Staphylococcus aureus. The corrected QT (QTc) interval was markedly prolonged upon admission (QTc 540 ms). He experienced torsades de pointes (TdP) several times and he was recovered after bystander cardiopulmonary resuscitation. The clinical course and the long QTc interval with deep inverted T wave were completely normalized 4 weeks after. He continued on triple antibiotic therapy for 45 days with a good revolution. The clinical features and the possible mechanisms of QT prolongation (inflammation, infection) of this patient are discussed.

No MeSH data available.


Related in: MedlinePlus