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Newby, D.E., Grubb, N.R., Bradbury, A., Davidson’s Principles and Practice of Medicine, Elsevier, 2017, 525-641.

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Article

A Case of Chronic Alcoholism and Torsades de Pointes

1Department of Internal Medicine, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA, USA


American Journal of Medical Case Reports. 2018, Vol. 6 No. 6, 117-120
DOI: 10.12691/ajmcr-6-6-5
Copyright © 2018 Science and Education Publishing

Cite this paper:
Daniel C. Sacher. A Case of Chronic Alcoholism and Torsades de Pointes. American Journal of Medical Case Reports. 2018; 6(6):117-120. doi: 10.12691/ajmcr-6-6-5.

Correspondence to: Daniel  C. Sacher, Department of Internal Medicine, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA, USA. Email: daniel.sacher@americanacademic.com

Abstract

Torsades de pointes is a form of polymorphic ventricular tachycardia due to prolonged ventricular repolarization represented by a prolonged QT interval on electrocardiogram. Common causes of QT prolongation are usually considered in the clinical setting, such as electrolyte imbalances, medication side effects, congenital syndromes. As recent research has proposed, long-term excessive alcohol use may also be a contributing factor. The effects of alcohol on the heart have been studied extensively, showing that chronic exposure leads to cellular events and structural changes in the heart that may ultimately result in adverse clinical events. This case report presents a patient with a history of chronic alcoholism that experienced torsades de pointes and sudden cardiac death during hospitalization for a severe chronic obstructive pulmonary disease exacerbation. She was given macrolide antibiotics despite a prolonged QTc on electrocardiogram with a history of prior syncopal events. While macrolide antibiotics are known to cause QTc prolongation, chronic alcohol use has also been shown to be associated with QT prolongation. Moreover, QT prolongation may be a predictor of sudden cardiac death in alcoholics. In addition to common medication class side effects, the effects of commonly abused and readily accessible substances such as alcohol, should also be taken into consideration.

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