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Who is at risk of developing torsade de pointes?
Can torsade de pointes be treated?

Torsade de pointes is classified as a variant of ventricular tachycardia. In order to assess that a patient is suffering from this type of disorder, it is necessary to carry out thorough investigations and monitor the heart function with an ECG. In the ECG recording, when torsade de pointes occurs, chaotic recordings become apparent, indicating abnormal heart function, chaotic ventricular activity. What does this mean? The nerve impulses that reach the heart propagate abnormally, causing unwanted changes in the heart's work - the heart chambers are not performing their role properly, not ejecting blood into the circulatory system. In a person who suffers from torsade de pointes, sudden cardiac arrest occurs, which requires immediate medical attention. Failure to do so can result in death. Torsade de pointes is a variant of ventricular tachycardia. Ventricular tachycardia involves the occurrence of a cardiac arrhythmia. The normal heart rhythm is regular, between 60 and 100 beats per minute. Both a sudden acceleration of the heart (tachycardia) and a slowing down of the heart (bradycardia) are considered arthymia. Cardiac arrhythmias can originate from abnormal functioning of the atria, in which case there is an atrial arrhythmia, such as atrial fibrillation or flutter. Heart rhythm disturbances can also be caused by problems in the heart's ventricles - e.g. ventricular flutter, ventricular fibrillation, ventricular tachycardia.

Who is at risk of developing torsade de pointes?

People who are at risk of developing torsade de pointes are primarily those who suffer from conditions that cause prolongation or shortening of the QT intervals, which are the segments on the ECG line showing the workings of the heart muscle. Another group of people who are at risk of developing torsade de pointes syndrome are those who suffer from heart disease, hypertension, atherosclerosis and those who are genetically burdened with cardiac problems.

Disease entities that increase the risk of torsade de pointes are primarily:

long QT synd rome - manifests as problems in the proper functioning of ion channels in the myocardium; the problems primarily affect the sodium and potassium channels. Interestingly, the symptoms of long QT syndrome - such as syncope - occur primarily in young people aged 5-15 years. When the disease occurs in older people, the diagnosis is usually only made when severe arrhythmia, cardiac arrest and sudden loss of consciousness occur,
short QT syndrome - a disease entity characterised by abnormally short QT episodes in the ECG recording,
brugada synd rome - is a disease caused by mutations in genes encoding proteins that are responsible for the normal functioning of sodium and calcium channels located in the heart. Abnormalities of the sodium channels lead to problems with the heart chambers and can lead to torsade de pointes,
myocardialinfarction - this results in scar tissue on the heart, i.e. malfunctioning tissue. This is nothing more than heart tissue that does not show proper functioning and therefore can generate additional impulses that, by propagating in directions that are not correct, generate additional contractions of the heart muscle,
cardiomyopathy - a disease involving damage to the fibres of the heart muscle, resulting in impaired conduction of nerve impulses. Nerve impulses that propagate in this way cause additional contractions of the heart, which manifests itself as ventricular fibrillation, ventricular tachycardia,
endocrine disorders - normal hormone management affects the functioning of the entire body. When hormonal problems occur, they can affect the normal functioning of the heart,
ion balance probes - disturbances in the correct ratio of ions, especially of sodium, potassium and calcium, can promote the appearance of problems in the normal functioning of the heart. Ion abnormalities are primarily due to the malfunctioning of ion channels, which are located in the myocardium. Defective discharge of ions and disruption of their homeostasis leads to problems with the flow of electrical impulses in the heart, resulting in the appearance of inappropriate contractions and thus an erroneous ECG recording.

Can torsade de pointes be treated?

It is extremely difficult to diagnose the possibility of torsade de pointes. It usually occurs suddenly - only after cardiac arrest is the disease entity identified. Nevertheless, people who suffer from shortness of breath, palpitations, dizziness, have episodes of fainting or syncope should ask their GP to examine their heart. Patients suffering from cardiomyopathy or those who have undergone a heart attack should observe their body closely and report any deviation from normal to their doctor. A diagnostic method that indicates that the heart is not working properly is to perform an ECG test. A Holter test, which is an ECG that monitors the heart for 24 hours, provides valuable data on heart function. Unfortunately, ventricular tachycardia of the torsade de pointes type often occurs suddenly, with no previous alarming signals. When this type of tachycardia occurs, medical intervention is essential - without it, there is a real threat to the patient's life.

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