# A Scary Tale of a Twisted Storm: A Case Report of Torsades De Pointes in Acquired Long QT Syndrome

## TL;DR

A 64-year-old woman with a heart condition experienced dangerous heart rhythm episodes, which were managed by adjusting her electrolyte levels.

## Contribution

This case report highlights the importance of recognizing and managing torsades de pointes in acquired long QT syndrome.

## Key findings

- A 64-year-old woman presented with syncope and prolonged QT interval leading to torsades de pointes.
- Electrolyte modulation was effective in preventing sudden cardiac death in this case.

## Abstract

Torsade de pointes (TdP, meaning “twisting of the points”) is a polymorphic ventricular tachycardia (VT) characterized by twisting QRS complexes around the isoelectric line, typically associated with prolonged QT intervals from congenital or acquired causes. A 64-year-old woman with hypertension presented with recurrent syncope and bradycardia. A 12-lead electrocardiogram (ECG) revealed a 2:1 atrioventricular block (AVB) and a prolonged corrected QT (cQT) interval (544 ms). Holter monitoring showed repeated episodes of TdP correlating with her symptoms. This case underscores prompt recognition and treatment to prevent sudden cardiac death - in this case, by electrolyte modulation.