Acute respiratory distress syndrome with transiently impaired left ventricular function and Torsades de Pointes arrhythmia unmasking congenital long QT syndrome in a 25-yr-old woman

Br J Anaesth. 2006 Aug;97(2):150-3. doi: 10.1093/bja/ael118. Epub 2006 May 23.

Abstract

We report a case of recurrent episodes of Torsades de Pointes arrhythmia in the setting of transiently impaired left ventricular ejection fraction, acute respiratory distress syndrome, transient hypokalaemia and QT-prolonging drugs, in a previously healthy 25-yr-old female patient. In the course of the clinical and genetic work-up this patient was newly diagnosed with a mutation in KCNH2 encoding the alpha-subunit of the human repolarizing potassium channel I(Kr). This case report illustrates the multivariate nature of long-QT syndrome, and emphasizes the usefulness of a pharmacological test for repolarization abnormalities.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / adverse effects
  • Antifungal Agents / adverse effects
  • ERG1 Potassium Channel
  • Echocardiography / methods
  • Erythromycin / adverse effects
  • Ether-A-Go-Go Potassium Channels / genetics
  • Female
  • Fluconazole / adverse effects
  • Humans
  • Hypokalemia / complications
  • Hypokalemia / physiopathology
  • Long QT Syndrome / complications
  • Long QT Syndrome / congenital*
  • Long QT Syndrome / physiopathology
  • Mutation / genetics
  • Recurrence
  • Respiratory Distress Syndrome / etiology*
  • Respiratory Distress Syndrome / physiopathology
  • Torsades de Pointes / complications*
  • Torsades de Pointes / physiopathology
  • Treatment Outcome
  • Ventricular Dysfunction, Left / complications*
  • Ventricular Dysfunction, Left / physiopathology

Substances

  • Anti-Bacterial Agents
  • Antifungal Agents
  • ERG1 Potassium Channel
  • Ether-A-Go-Go Potassium Channels
  • KCNH2 protein, human
  • Erythromycin
  • Fluconazole