Pemanjangan Interval QT Terkoreksi (QTc) pada Pasien Hipokalemia Berat dengan Penyulit Aritmia Ventrikel Fatal

Filipus Michael Yofrido (Faculty of Medicine, Widya Mandala Catholic University Surabaya)
Ika Christine (Faculty of Medicine, Widya Mandala Catholic University Surabaya)
Lila Tri Harjana (Rumah Sakit Darmo Surabaya)

Jurnal Widya Medika
Vol. 4 No. 2 (2018)

QT prolongation (QTc > 440 ms) is risk factor for ventricular arrhythmias, especially Torsade de Pointes. It be caused by congenital, hypokalemia, hypocalcemia, hypomagnesemia, and drugs.Meticulous monitoring, immediate treatment of underlying, and avoiding drug-induceQT prolongation are useful to prevent lethal event.A 66-years-old man came to emergency department with nausea, postural imbalance, constipation, and history of periodic hypokalemia. 12-lead ECG revealed sinus rhythm with QT prolongation (QTc 650 ms). Laboratory showed hypokalemia, hyponatremia, hypocalcaemia, hypomagnesaemia, and hyperglycemia. He treated with omeprazole, ondansetron, sodium phosphate enema, and metoclopramide for his symptoms. Three hours later, he was suddenly collapse and ECG showed polymorphic Ventricular Tachycardia (VT) Torsade de Pointes. Magnesium sulfate and CPR were given. Fourthy-five minutes resuscitation didn’t return of spontaneous circulation and he was dead.