Levofloxacin-induced torsades de pointes
Abstract
A 91-year-old woman, presenting with flu-like symptoms, developed a brief episode of polymorphic ventricular tachycardia in the emergency department. The arrhythmia resolved spontaneously, and a subsequent electrocardiogram revealed Q waves and ST-segment elevation in the anterior precordial leads, along with a prolonged QT interval. The presumed diagnosis was ST-segment-elevation myocardial infarction with ischemia-induced ventricular tachycardia. Emergent coronary artery angiography revealed only minimal luminal irregularities. It was discovered that the patient had been taking levofloxacin and, apparently as a result, developed drug-induced torsades de pointes. The case of this patient is an example of the difficulties that are occasionally encountered in differentiating ST-segment-elevation myocardial infarction from nonischemic ST elevation.
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