key: cord-0769125-2ho4qe1f
authors: Beer, Dominik; Isakadze, Nino; McClellan, Rebecca; Calkins, Hugh; Barth, Andreas S.
title: Acquired Long QT and Ventricular Arrhythmias in the Setting of Acute Inflammation: A Case Series
date: 2021-07-21
journal: JACC Case Rep
DOI: 10.1016/j.jaccas.2021.04.034
sha: 324fb811ae21f673104d0b536ebe7fbc69396952
doc_id: 769125
cord_uid: 2ho4qe1f

We report a case series of 4 patients with transient marked QTc prolongation and ventricular arrhythmias in the setting of inflammation with very high ferritin levels. Three patients were positive for coronavirus disease-2019. In the setting of an acute rise in inflammatory markers, electrocardiography screening for QTc prolongation is warranted. (Level of Difficulty: Beginner.)

A ccumulating data implicate inflammation as a potential cause of acquired long QT syndrome (LQTS) (1, 2) . This case series highlights the importance of acute inflammation for QT prolongation in cases of acquired LQTS.

A 49-year-old man with thalassemia major compli- 

A 50-year-old woman with a history of ESRD presented to the emergency department with tachycardia, cough, and shortness of breath and was found to be positive for COVID-19. She was empirically started on aztreonam 500 mg and doxycycline 100 mg twice daily. An echocardiogram showed an LV ejection fraction of 40% to 45%, severe mitral regurgitation, and a small circumferential pericardial effusion.

Her TnI level was elevated at 0.22 ng/ml ( Table 1) . One We conclude that acute inflammation is a clinically important QT-prolonging condition. In the setting of an acute rise of inflammatory markers, ECG screening for QTc prolongation is warranted, and QT-prolonging drugs should be avoided.

The authors have reported that they have no relationships relevant to the contents of this paper to disclose. 

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