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Heart Disease (Expert Forum)
Torsade
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Torsade
by defcoach, Mar 28, 2001 12:00AM
Hi,
I'm 40 years old and in reasonably good health. Two weeks ago, after going jogging, my heart suddenly started to pound unbeliveably fast(felt like it was going to explode). It was very difficult to breathe and I broke out into a cold, profuse sweat. After I started sweating, I collapsed and my wife called 911. I was taken to the hospital and the doctor said that I had an irregular heartbeat called Torsade. The had to put me on a pacemaker to get my heart to beat normally again. They are currently putting me through a battery of tests to see why this happened.
My questions are: What is Torsade? What could have caused it? and Is it life-threatening?
Thank you.
I'm 40 years old and in reasonably good health. Two weeks ago, after going jogging, my heart suddenly started to pound unbeliveably fast(felt like it was going to explode). It was very difficult to breathe and I broke out into a cold, profuse sweat. After I started sweating, I collapsed and my wife called 911. I was taken to the hospital and the doctor said that I had an irregular heartbeat called Torsade. The had to put me on a pacemaker to get my heart to beat normally again. They are currently putting me through a battery of tests to see why this happened.
My questions are: What is Torsade? What could have caused it? and Is it life-threatening?
Thank you.
Doctor's Answer
by CCF-M.D.-CRC, Mar 28, 2001 12:00AM
Dear def,
Torasade de points (from the French "twisting around a point") is a type of ventricular tachycardia. It often presents as a pounding heartbeat or as fainting. It is diagnosed with ECG or Holter monitor testing. The duration of torsades is usually brief (less than 20 seconds) but it may be sustained and can degenerate into ventricular fibrillation.
Torsades is characterized by a finding on the ECG called a prolonged QT. There are a number of different causes of torsades as follows: congenital, drugs (many antiarrhythmic agents, phenothiazines, haloperidol, cisapride, tricyclic antidepressants, antibiotics including erythromycin and trimethoprim-sulfa, some antihistamines and antifungal agents), electrolyte abnormalities, hypothyroidism, strokes or other CNS events, heart attack, severe heart failure, starvation diets, organophosphate poisioning, myocarditis and mitral valve prolapse.
Slow heart rates can promote torsades in patients with a prolonged QT interval but it is not clear that bradycardia by itself predisposes to torsades.
Acute therapy for torasdes is aimed at terminating the arrhythmia. This may be accomplished with electrical cardioversion if the patient is unstable. If the blood pressure is stable magnesium given intravenously often terminates torsades. Bradycardia can be corrected with temporary pacing. Chronic therapy depends on the cause and may include stopping the offending drug, correcting the underlying heart problem and/or permanent pacing.
Torasade de points (from the French "twisting around a point") is a type of ventricular tachycardia. It often presents as a pounding heartbeat or as fainting. It is diagnosed with ECG or Holter monitor testing. The duration of torsades is usually brief (less than 20 seconds) but it may be sustained and can degenerate into ventricular fibrillation.
Torsades is characterized by a finding on the ECG called a prolonged QT. There are a number of different causes of torsades as follows: congenital, drugs (many antiarrhythmic agents, phenothiazines, haloperidol, cisapride, tricyclic antidepressants, antibiotics including erythromycin and trimethoprim-sulfa, some antihistamines and antifungal agents), electrolyte abnormalities, hypothyroidism, strokes or other CNS events, heart attack, severe heart failure, starvation diets, organophosphate poisioning, myocarditis and mitral valve prolapse.
Slow heart rates can promote torsades in patients with a prolonged QT interval but it is not clear that bradycardia by itself predisposes to torsades.
Acute therapy for torasdes is aimed at terminating the arrhythmia. This may be accomplished with electrical cardioversion if the patient is unstable. If the blood pressure is stable magnesium given intravenously often terminates torsades. Bradycardia can be corrected with temporary pacing. Chronic therapy depends on the cause and may include stopping the offending drug, correcting the underlying heart problem and/or permanent pacing.
