Aashi
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A 32-year-old woman came to the hospital with complaints of recurrent syncope for the last five years. She had her last syncopal episode two hours ago, which lasted for several seconds and was associated with chest discomfort, palpitations, and diaphoresis. She has history of Graves' disease for three years and for which she was originally treated with propylthiouracil and maintained on propranolol. The patient claims that her father had a heart attack at the age of 78 and her mother died suddenly at the age of 42. Telemetry during the current hospitalization shows multiple episodes of nonsustained, polymorphic ventricular tachycardia (VT) with an undulating amplitude and a prolonged QT interval during which she experienced lightheadedness followed by syncope. What is the best management for this patient?
(A) Amiodarone
(B) Implantable cardioverter/defibrillator
(C) Stop propranolol
(D) Cervicothoracic sympathectomy
(E) Quinidine
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| robin082006
Forum Hero
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This is congenital prolonged QT syndrome--->Beta Blocker is DOC.
But this patient is using beta Blocker but not effective, therefore I go with B---->Implantable cardioverter/defibrillator
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| CocaCola
Forum Guru
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????
Seems like the best answer here would be B - implantable cardiovert/defib
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| prathapdoctor
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i will go with B.
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| MDcooper
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i will go with B too
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| Aashi
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yes its B..
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| webjeee
Forum Guru
Topics: 99
Posts: 349
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congenital prolonged QT syndrome or torsade?
Just because family history?
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