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Hyperchloremia
1%
3/296
Hypophosphatemia
0%
1/296
Hyperkalemia
31%
92/296
Hypercalcemia
8%
23/296
Hypomagnesemia
59%
174/296
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This patient's heart rhythm is consistent with Torsades de Points (TdP), which can be precipitated by hypomagnesemia. TdP is polymorphic ventricular tachycardia with increasing and decreasing amplitude. Conditions that predispose patients to TdP include hypomagnesemia, hypokalemia, hypocalcemia, long QT interval. First-line treatment includes a magnesium (magnesium sulfate) bolus and sometimes exogenously increasing the heart rate (i.e isoproterenol or pacing). Defibrillation is indicated in patients who are hemodynamically unstable. While some episodes of TdP can be deadly, most cases resolve spontaneously. Figure A depicts a cardiac tracing of TdP. Incorrect Answers: Answers 1, 2: These electrolytes are not known to influence the risk of TdP. Answer 3: Hypokalemia is risk factor for TdP. Answer 4: Hypocalcemia is a risk factor for TdP.
4.6
(8)
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