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2014, Number 4

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Rev Mex Pediatr 2014; 81 (4)

Torsades de pointes and pharmacogenomic latent life-threatening in the setting of emergency department

Quintero AE, Sevilla BJ, Sánchez BIP, Segoviano SM

Language: Spanish
References: 25
Page: 138-142
PDF size: 754.67 Kb.


ABSTRACT

Torsades de Pointes is a polymorphic lethal potentially ventricular taquiarrhythmia characterized by a change in the amplitude and morphology of the QRS complexes, consequence previously QT long acquired or congenital. In patients with severely injury of the CNS it is a latent risk. We present the case of a child with neurological impairment secondary to near drowning who present non-congenital QT long and late develop TdP, the treatment was magnesium sulfate for the acute episode and propranolol for prevention controlling the arrhythmia and become hemodynamic stability. Other risk factors in the development of TdP, are as cardiac (congestive heart failure, a QT myocardial infarction, congenital long QT syndrome) and such as extracardiac (female sex, polipharmacy, electrolytes imbalance) mediated farmacogenomic complex mechanisms. The diagnosis has to be opportune and the outcome with electrocardiogram impressed.


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