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Question 34 of 238

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A 60-year-old man is transferred from the local psychiatric unit to the Emergency Department. Throughout the day he has complained of palpitations and feeling light-headed. The psychiatry consultant noted he was tachycardic and requested a transfer. An ECG taken following admission shows a broad complex tachycardia consistent with torsardes de pointes, rate 120/min. His blood pressure is 122/80 mmHg and there are no signs of heart failure. What is the most appropriate management?

B C D E

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A. Intravenous naloxone B. Intravenous magnesium sulphate C. DC cardioversion D. Intravenous amiodarone E. Intravenous verapamil
January 2012 exam

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Torsades de pointes Torsades de pointes ('twisting of the points') is a rare arrhythmia associated with a long QT interval. It may deteriorate into ventricular fibrillation and hence lead to sudden death Causes of long QT interval congenital: Jervell-Lange-Nielsen syndrome, Romano-Ward syndrome antiarrhythmics: amiodarone, sotalol, class 1a antiarrhythmic drugs tricyclic antidepressants antipsychotics chloroquine terfenadine erythromycin electrolyte: hypocalcaemia, hypokalaemia, hypomagnesaemia myocarditis hypothermia subarachnoid haemorrhage

Management IV magnesium sulphate

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