Quote:
Originally Posted by olddoc
1. Torsades de pointes
2. Magnesium
3. QTc prolonging meds and conditions
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Not all ventricular tachycardia is created equal. Olddoc has identified that this is Torsades de Pointes, a form of polymorphic ventricular tachycardia associated with prolonged QT syndrome. Its worth remembering that not all polymorphic VT is Torsades and polymorphic VT can be caused by coronary ischemia, but in this case you feel very comfortable diagnosing Torsades given the morphology of the tracing and the fact that the patient came in with a QTc of 652.
So you give magnesium, confident that in every ACLS training you've ever done Torsades patients get better immediately when magnesium is administered. You start preparing for your victory lap around the emergency department when one of the nurses nudges you and says:
"hey Doc, he's still in pulseless Torsades. What do we do now?"