The patient is being treated with intravenous quinidine for malaria that was contracted while in Africa. Several hours after administration of the medication, the patient develops palpitations and dizziness. Electrocardiogram shows tachycardia and twisting of the QRS complexes around an isoelectric line. Which best describes the most likely etiology of this patient’s arrhythmia?

Question

The patient is being treated with intravenous quinidine for malaria that was contracted while in Africa. Several hours after administration of the medication, the patient develops palpitations and dizziness. Electrocardiogram shows tachycardia and twisting of the QRS complexes around an isoelectric line. Which best describes the most likely etiology of this patient&rsquo;s arrhythmia?

Accepted Answer

Drug-mediated prolongation of the QT interval. This patient presents with signs and symptoms of torsade de pointes, namely palpitations, dizziness, tachycardia, and twisting of the QRS complexes around an isoelectric line on ECG. The etiology of torsade de pointes is a prolonged QT interval typically caused by electrolyte imbalances, genetic predisposition, or drugs, such as quinidine. Irritation of the cardiac myocardium can cause premature ventricular contractions. AV nodal reentrant tachycardia describes Wolff-Parkinson-White syndrome. Torsade de pointes is caused by prolonged ventricular repolarization.

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