PMC7739200_01
Baseline electrocardiogram (ECG) of lead I - V6 (A) and lead II (B). QT = 380 ms, RR = 640 ms and QTc = 441 ms (Fridericia), 475 (Bazett).. Red vertical bars are showing where the beginning of the QRS and the end of T wave.
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Her baseline electrocardiogram (ECG) (Figure 1) showed a normal sinus rhythm of 94 bpm with QT interval and Fridericia's corrected QT interval (QTc) of 380 and 441 ms (475 ms with Bazett's formula), respectively.
Chest X-ray (CXR) on admission (left). CXR on the third day of admission (middle). CXR before admitted to the intensive care unit.
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On the fifth day of hospitalization, her respiratory condition deteriorated (Figure 2).
(A) Torsade de pointes (TdP), (B) The lead II of electrocardiogram (ECG) 1 hour preceding the torsade de pointes (TdP). QT = 200 ms, RR = 320 ms and QTc =292 ms (Fridericia), 353 (Bazett), and (C) The electrocardiogram (ECG) after the torsade de pointes (TdP). The ECG was taken 10 minutes after the return of spontaneous circulation (ROSC). Macroscopic T-wave alternans are shown by the vertical arrows. QT = 520 ms, RR = 240 ms and QTc = 664 ms (Fridericia), 751 ms (Bazett).
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The first arrhythmia was TdP (Figure 3A), which was preceded by sinus tachycardia (Figure 3B) with Fridericia QTc of 292 ms (353 ms with Bazett). After 2 minutes of CPR, the patient was on return of spontaneous circulation with sinus tachycardia and evident T-wave alternans (Figure 3C).