Large T Waves on Amiodarone + Haloperidol

Report:

Sinus rhythm 60/min

Nonspecific T wave changes

?TU waves

Prolonged QT interval 0.58”

QTc 0.58”

Comment:

The patient was on amiodarone infusion for previous AF (Fig 67a) and haloperidol for what, after extubation, was to become a delirium, as well as dexamedetodine (anticipating stormy extubation).

I thought, looking at her large positive T waves and their QT interval, that she had a CVA, but there were no focal or lateralising signs, and the brain scan was normal. She developed left middle cerebral thrombosis four years later, but the ECG could not have been predicting that! Her potassium was normal: large TU waves could not be ascribed to hypokalæmia (v. Case 71).

Thus, sometimes a complete explanation is lacking. At least the relatively new drug, dexamedetodine, could not be blamed. It merely contributed to her relative bradycardia.

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