A Toxic Combination
This case reminds the physician to be cautious when administering QT-prolonging medications to patients with underlying heart disease. A 73-year-old man with a known history of chronic obstructive pulmonary disease presented to the emergency department with severe dyspnea and altered mental status. He was promptly intubated by the emergency department physicians, placed on mechanical ventilation, and given intravenous levofloxacin and corticosteroids. He was transferred to the medical intensive care unit for management. An electrocardiogram (ECG) taken at admission showed signs of left ventricular hypertrophy and a QTc interval (QT interval corrected for heart rate) of 450 msec. (Source: The American Journal of Medicine)
