![]() TdP is a rare version of polymorphic ventricular tachycardia characterized by a pattern of alternating amplitudes, or “twisting points,” on ECG. QT prolongation puts patients at risk of dysrhythmias such as torsades de pointes (TdP). Other QT-prolonging conditions include hypothermia, myocardial ischemia, increased intracranial pressure, and congenital long QT syndrome. ![]() Several electrolyte disturbances can also prolong the QT interval including hypokalemia, hypomagnesemia, and hypocalcemia. There are many drugs associated with QT prolongation including but not limited to methadone several classes of antimicrobials antifungals antiretrovirals antiemetics antipsychotics and class IA, IC, and III antidysrhythmics. The QT interval corresponds to the time period from ventricular depolarization and contraction to ventricular repolarization and relaxation. One effect many drugs, both pharmaceutical and recreational, have on the heart is to prolong the QT interval. When caring for the poisoned patient, it is essential to rapidly detect dysrhythmias or to determine the risk of the patient developing a dysrhythmia.
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