ABNORMAL T WAVE INVERSIONS AND EXTREME QT PROLONGATION
Journal
Academic Medical Journal
Date Issued
2022
Author(s)
Janushevski Filip
DOI
10.53582/AMJ2221126g
Abstract
Introduction: Cardiovascular diseases are the cause of sudden cardiac arrest. One of
the leading causes of death is the occurrence of ventricular arrhythmias. Prompt evaluation,
diagnosis and management of ventricular arrhythmias are life-saving for these patients.
Case report: We present the case of a 70-year-old female patient with neurological
sensorimotor polyneuropathy with quadriparesis and verified chronic renal failure (CRF) gr.
IV admitted at the University Clinic for Nephrology for acute renal failure. After hemodialysis
treatment, she developed arrhythmogenic disability such as episodes of ventricular fibrillation
(VF) and ventricular tachycardia (VT). The onset of VT/VF required pharmacologic and shock
therapy treatment. Electrocardiogram (ECG) at presentation upon admission to the cardiology
clinic was with abnormal T wave and QT inversions. We did not find any electrolytic
disturbances or echocardiographic abnormalities in search for ischemia segment wall changes.
Coronary angiography showed no significant lesions of the coronary arteries. Our strategy for
treating this long QT interval was temporary pacing with high doses of b-blockers. According
to the good response to the therapy, the patient got permanent pacing therapy (AAIDDD
mode) and till this day she is still safe from occurrence of ventricular arrhythmias.
Conclusion: Prolongation of ventricular repolarization in patients with long QT interval
must be registered as a predictor of occurrence of ventricular arrhythmias
the leading causes of death is the occurrence of ventricular arrhythmias. Prompt evaluation,
diagnosis and management of ventricular arrhythmias are life-saving for these patients.
Case report: We present the case of a 70-year-old female patient with neurological
sensorimotor polyneuropathy with quadriparesis and verified chronic renal failure (CRF) gr.
IV admitted at the University Clinic for Nephrology for acute renal failure. After hemodialysis
treatment, she developed arrhythmogenic disability such as episodes of ventricular fibrillation
(VF) and ventricular tachycardia (VT). The onset of VT/VF required pharmacologic and shock
therapy treatment. Electrocardiogram (ECG) at presentation upon admission to the cardiology
clinic was with abnormal T wave and QT inversions. We did not find any electrolytic
disturbances or echocardiographic abnormalities in search for ischemia segment wall changes.
Coronary angiography showed no significant lesions of the coronary arteries. Our strategy for
treating this long QT interval was temporary pacing with high doses of b-blockers. According
to the good response to the therapy, the patient got permanent pacing therapy (AAIDDD
mode) and till this day she is still safe from occurrence of ventricular arrhythmias.
Conclusion: Prolongation of ventricular repolarization in patients with long QT interval
must be registered as a predictor of occurrence of ventricular arrhythmias
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