METHODS: This case is of a 51-year-old Caucasian female patient who presented with vomiting associated with hypokalemia and hypomagnesemia. She subsequently received ondansetron and metoclopramide, on the background of chronic treatment with fluoxetine. She then suffered an in-hospital monitored cardiac arrest, with features of long QT and torsades de pointes retrospectively noted on her prearrest electrocardiogram. She was diagnosed with acquired long QT syndrome, and her QT interval later normalized after removal of offending causes.
CONCLUSIONS: This case highlights the importance of proper consideration prior to prescribing QT prolonging medications, especially in patients who have other risk factors for prolonged QT, such as electrolyte disturbances and pretreatment with QT prolonging medications.
方法:本病例为一名51岁的白种人女性患者,出现呕吐伴低钾血症和低镁血症。她随后接受了昂丹司琼和甲氧氯普胺,在氟西汀慢性治疗的背景下。然后她遭受了医院内监测的心脏骤停,具有长QT和尖端扭转的特征,回顾性地记录在她的停搏前心电图上。她被诊断患有获得性长QT综合征,她的QT间期后来在去除不良原因后恢复正常。
结论:这个案例突出了在开QT延长药物之前适当考虑的重要性,特别是在有其他危险因素的患者中,QT延长,如电解质紊乱和QT延长药物预处理。