Síndrome del QT largo y muerte súbita cardiovascular
Abstract
RESUMENFundamento: el síndrome de QT largo es una canalopatía arritmogénica, caracterizada por una grave alteración en la repolarización ventricular, traducida electrocardiográficamente por una prolongación del intervalo QT, que predispone a la muerte súbita por arritmias ventriculares malignas, del tipo torsada de punta.
Objetivo: presentar un caso de síndrome QT poco frecuente en nuestro medio.
Caso Clínico: paciente de 31 años de edad con antecedente de salud, que ingresó en dos ocasiones durante su embarazo por cifras elevadas de tensión arterial en el año 2013. Presentó varios cuadros de sincope del cual se recuperaba espontáneamente. Ingresó en enero de 2014 por trastornos dispépticos y epigastralgia, al estar hospitalizada hizo un cuadro de sincope y taquicardia ventricular documentadas por electrocardiograma, donde llegó hacer torsada de punta y parada cardiorrespiratoria, por lo que fue necesario la reanimación cardiorrespiratoria y entubación endotraqueal, así se mantuvo 48 horas y salió de este cuadro. Se trasladó al instituto de cardiología en ciudad de la habana, donde fue estudiada por el equipo de arritmias y se decidió la implantación de un dispositivo de desfibrilación automático implantable.
Background: long QT syndrome is an arrhythmogenic canalopathy characterized by a serious al-teration in the ventricular repolarization, translated electrocardiographically by a prolongation of the QT in-terval that predispose to sudden death caused by malignant ventricular arrhythmias tracing in torsades de pointes.
Objective: to present the clinical case of a patient with this syndrome that is infrequent in our en-vironment.
Clinical case: a thirty-one-year-old patient with antecedents of being a healthy person, who was admitted in the hospital twice during her pregnancy because of high arterial pressure in 2013. The patient presented syncope manifestations from which she recovered spontaneously. In January 2014, the patient is admitted in the hospital with dyspeptic disorders and epigastralgia. After being admitted, the patient presented synco-pe manifestations and ventricular tachycardia exhibited on the electrocardiogram tracing in torsades de pointes and cardiac arrest. It was necessary to perform a cardiopulmonary resuscitation and endotracheal intubation. The patient presented this combination of manifestations for 48 hours. She is sent to the Cardiol-ogy Institute of Havana where she is studied by the arrhythmia medical team and the implantation of an im-plantable cardioverter-defibrillator is decided.
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22 julio 2025