• Am J Emerg Med · Dec 2013

    Case Reports

    Torsade de pointes indicates early neurologic damage in acute ischemic stroke.

    • Li-Yen Huang, Wen-Yu Lin, Cheng-Chung Cheng, Shu-Meng Cheng, and Tsung-Neng Tsai.
    • Department of Internal Medicine, Division of Cardiology, Armed Forces Taoyuan General Hospital, Taoyuan, Taiwan; Department of Internal Medicine, Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
    • Am J Emerg Med. 2013 Dec 1;31(12):1719.e5-7.

    AbstractTorsade de pointes (TdP) is a life-threatening polymorphic ventricular tachycardia that is related to QT prolongation. Although QT prolongation is commonly seen in acute stroke, TdP is rare. We report the case of a 78-year-old woman with ischemic stroke who presented with TdP as the initial manifestation of early neurologic deterioration. We hypothesized that an increase in intracranial pressure may result in neurohormonal activation, QT prolongation, and then myocardial damage, leading to TdP. We highlight that new onset of TdP in a patient with stroke may reflect neurologic deterioration, requiring further evaluation and specific intervention.

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