Korean Circ J.  2013 May;43(5):340-342. 10.4070/kcj.2013.43.5.340.

Acquired Long QT Syndrome Manifesting with Torsades de Pointes in a Patient with Panhypopituitarism due to Radiotherapy

• Kang DG
• Kim SE
• Park MS
• Kim EJ
• Lee JH
• Park DG
• Han KR
• Oh DJ

• KMID: 2224931
• DOI: http://doi.org/10.4070/kcj.2013.43.5.340

Abstract

We describe a 64-year-old male patient with panhypopituitarism who experienced polymorphic ventricular tachycardia (VT) associated with long QT intervals. The panhypopituitarism developed as a sequelae of radiation therapy administered 20 years prior to his current presentation and was recently aggravated by urinary tract infection with sepsis. In this case, polymorphic VT was resistant to conventional therapy (including magnesium infusion), and QT prolongation and T wave inversion were normalized after the administration of steroid and thyroid hormones. Thyroid hormone is generally known to be associated with torsades de pointes (TdP), but steroid or other hormones may also provoke TdP. Hormonal disorders should be considered as a cause of polymorphic VT with long QT intervals. Some arrhythmias can be life-threatening, and they can be prevented with supplementation of the insufficient hormone.

Keyword

Tachycardia, ventricular; Torsades de pointes; Hypopituitarism; Radiotherapy

MeSH Terms

Arrhythmias, Cardiac
Humans
Hypopituitarism
Long QT Syndrome
Magnesium
Male
Sepsis
Tachycardia, Ventricular
Thyroid Gland
Thyroid Hormones
Torsades de Pointes
Urinary Tract Infections
Magnesium
Thyroid Hormones

Figure

• 

  Fig. 1 Electrocardiography conducted at the hospital on day 4 showed a section of TdP rhythm during a 20-second period.

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