A dangerous heart rhythm: Let's simply learn about Torsades de Pointes

Do you suddenly feel dizzy, your chest is pounding, your eyes are blue, and you feel like you're about to pass out? Sometimes this can be a sign of a dangerous heart rhythm. Today we're talking about one such rare but potentially dangerous condition. It's called Torsades de Pointes (a French word, pronounced "torsades de pointes"). The name may sound a bit strange, but it's important to know what it means and what it can do.

Simply put, what is Torsades de Pointes?

This is a very fast, abnormal, and dangerous heart rhythm that starts in the two lower chambers of your heart (ventricles). To be precise, this is a special type of fast heart rate (Ventricular Tachycardia). Normally, a healthy person's heart rate is between 60 and 100 beats per minute. However, when this condition occurs, the heart rate can increase to 150 to 300 beats per minute .

This is dangerous because there is a possibility of sudden cardiac death without any warning .

If you look at your EKG (electrocardiogram), there's a specific pattern that doctors see in this condition. It's a pattern of waves that twist back and forth, like a coil. The French word "Torsades de Pointes" means "twisting of the points." It gets its name from the twisted nature of the EKG.

This condition usually occurs with another problem in the heart's electrical activity. It's called a long QT interval. Simply put, the QT interval is the time it takes for your heart's lower chambers to beat once and then prepare for the next beat. If this time is abnormally long (long QT), an extra beat can occur, causing Torsades de Pointes.

What are the symptoms of this condition?

The scary thing here is that exactly half of people with this condition do not experience any symptoms . Those who do experience symptoms may experience the following. You should be very careful about these.

Why does this happen? What are the reasons?

There are two main categories of reasons for this.

1. Congenital causes: Some people are born with a genetic condition called `Long QT Syndrome`. This means that they have this condition in their family. These people are at higher risk of developing Torsades de Pointes.

2. Later causes: This is the most common. The `QT interval` can be prolonged by the use of certain medications and decreased levels of electrolytes in the body. This increases the risk of Torsades de Pointes.

Medications that increase the risk:

• Some medications that control heart rhythm (Antiarrhythmics)
• Some antibiotics
• Some medicines for vomiting (Antiemetics)
• Antifungals
• Antipsychotics are medications used to treat certain mental illnesses.
• Some medications for cancer

What are the risk factors for this?

Some people are more likely to develop this condition. These risk factors are:

• Having a condition called `Long QT Syndrome`.
• Having other heart diseases.
• Being a woman (women are at higher risk)
• Being over 65 years of age.
• Underactive thyroid.
• Having suffered a stroke.
• Use of diuretics.
• Slow heart rate (Bradycardia).
• Low levels of calcium, magnesium, or potassium in the body.
• Excessive diarrhea or vomiting.

Can the risk be reduced?

Yes, you definitely can. There are a few things you can do:

• If someone in your family has `Long QT Syndrome`, get yourself tested for it. If you have it, see a cardiologist before starting an exercise program.
• Be careful about the medications you take: If you are taking a medication that can prolong the `QT interval`, ask your doctor if you can take another medication instead. When starting a new medication, ask your doctor to make sure it will not cause problems with the medication you are currently taking.
• Think about nutrition: If your doctor recommends it, increase your calcium, magnesium, and potassium levels.
• Take your medication on time: To prevent this condition from recurring, use the medication exactly as prescribed by your doctor.
• Drink plenty of water: Maintain proper water and salt levels in the body.
• Know your heart rate: Learn what a normal heart rate is and how to measure it.
• If you have been given a heart monitor: If your doctor has given you a heart monitor to wear at home, be sure to wear it.

How is the diagnosis made?

The main way to diagnose this is with an `EKG` (Electrocardiogram) test. Doctors can recognize this by looking at the distinctive `twisted` pattern and the long `QT interval` seen on the `EKG`.

In addition, these tests can also be done:

• Blood tests: Check the levels of electrolytes in the body, such as magnesium and potassium.
• Echocardiogram: A scan to look at the structure and function of the heart.
• Heart Monitor: A device that is worn for several days and continuously monitors the heart's rhythm.

How is it treated?

Treatment depends on the cause of the condition. A person with congenital Long QT Syndrome will require longer-term treatment than someone with a drug-induced condition.

When should I see a doctor?

If you have to stay in the hospital due to Torsades de Pointes, you should definitely go home for a follow-up in two weeks. Since this is a condition with a risk of sudden death, it is essential that you remain under the constant supervision of a cardiologist.

You can ask your doctor these questions:

• Am I born with Long QT Syndrome, or is it caused by medication?
• What are the chances that this condition will also occur in other people in my family?
• Is there another medicine I can take instead of the one that caused this risk?

With treatment, this condition can be controlled and you can live a good life. However, if left untreated, it can be fatal. Therefore, it is very important to follow your doctor's instructions exactly and go to the clinics on the scheduled dates.