Mohammad Khalid Mojadidi, Ninel Hovnanians, Michael R Kaufmann, James A Hill
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A 55-year-old woman with a history of chronic bronchitis, Clostridium difficile colitis, and alcohol and tobacco abuse was admitted with altered mentation, hyponatremia, and necrotizing right-upper-lobe pneumonia. She was started on cefepime and vancomycin; metronidazole was added for colitis. A resting electrocardiogram (ECG) showed sinus tachycardia with a QS pattern in the precordial leads, normal intervals, and small T-wave inversions in leads V5 and V6. Four days later, significant changes in her baseline telemetry rhythm prompted a repeat 12-lead ECG; the patient's pulse rate was 75 beats/min with a QT interval of 720 ms and QTc of 746 ms (Fig. 1). Her troponin T level was <0.03 ng/mL, and she had no new symptoms. Her medications at that time were aspirin, metoprolol, lisinopril, cefepime, atorvastatin, pantoprazole, metronidazole, oral vancomycin, and subcutaneous heparin. Her potassium level was 2.9 mEq/L, and her magnesium level was 1.6 mEq/L. An echocardiogram showed severe left ventricular dysfunction with wall motion that suggested stress-induced cardiomyopathy.
期刊介绍:
For more than 45 years, the Texas Heart Institute Journal has been published by the Texas Heart Institute as part of its medical education program. Our bimonthly peer-reviewed journal enjoys a global audience of physicians, scientists, and healthcare professionals who are contributing to the prevention, diagnosis, and treatment of cardiovascular disease.
The Journal was printed under the name of Cardiovascular Diseases from 1974 through 1981 (ISSN 0093-3546). The name was changed to Texas Heart Institute Journal in 1982 and was printed through 2013 (ISSN 0730-2347). In 2014, the Journal moved to online-only publication. It is indexed by Index Medicus/MEDLINE and by other indexing and abstracting services worldwide. Our full archive is available at PubMed Central.
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