TOPIC: Cardiovascular Disease TYPE: Medical Student/Resident Case Reports INTRODUCTION: Azithromycin (AZ) is extensively used, with millions of prescriptions written yearly. In 2013 US food and drug administration issued a warning against the pro-arrhythmogenic activity this in presence pre-existing cardiac conditions, known QT prolongation or QT-prolonging use electrolyte abnormalities.(1) A r...

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 (T...

A case of methadone-induced torsades de pointes is presented to demonstrate clinical features that predispose patients to this serious cardiac arrhythmia. A patient who was receiving methadone maintenance treatment for heroin addiction presented to the hospital with dizziness and near-syncope. He was taking a relatively high dose of methadone but was not taking any concomitant cytochrome P450 i...

Prolongation of QTC is an electrocardiographic finding indicating prolongation of cardiac repolarization, which increases the risk for torsades de pointes, a form of ventricular tachycardia that can lead to sudden cardiac death. Sudden cardiac death in the setting of antipsychotic treatment was first described in the 1960s with thioridazine; since that time, many other psychotropic medications ...

BACKGROUND Several frequently used antibiotics are associated with an arrhythmia called "torsades de pointes" (TdP). This potentially fatal arrhythmia is considered unpredictable. METHODS In order to investigate the prevalence of risk factors for TdP prior to initiation of antibiotic therapy, we conducted a literature search for all published reports on TdP induced by antibiotics and we asked...

Torsades de pointes (TdP) tachycardia is a rare polymorphic ventricular tachycardia characterized by short, self-limiting runs, and a prolonged QT interval, which can deteriorate into persistent ventricular fibrillation and sudden death. This arrhythmia is gaining importance, since it is known to be related to commonly prescribed drugs and electrolyte abnormalities. Most of the drugs that induc...

Two cases of QT prolongation and torsades de pointes (TdP) are presented. The patients had been taking clarithromycin (400 mg/day) for respiratory disease. Although erythromycin is reportedly associated with TdP, this is the first report of clarithromycin associated with TdP in the absence of other drugs already known to produce QT prolongation.

Methadone is a synthetic opioid that has been used successfully to treat heroin addiction and chronic pain. It is usually well tolerated and has few side effects. Recently, an association with torsade de pointes has been reported. We present 4 cases of torsade de pointes during methadone treatment.