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Metoclopramide as a Possible Cause of Prolonged QT Syndrome and Torsade de Pointes in a Patient With Heart Failure and Renal Insufficiency
- Sultan M. Siddique, MD;
- Nasir Shariff, MD;
- Nimesh Vesuwala, MD; and
- Tariq Hafiz, MD
- From Lehigh Valley Hospital, Allentown, PA 18104; Pottsville Hospital, Pottsville, PA 17901; and Pottsville Internist Associates, Pottsville, PA 17901.
Background: The long QT syndrome is a disorder of myocardial repolarization characterized by a prolonged QT interval and is associated with an increased risk for torsade de pointes. Metoclopramide is known to block ion channels, causing QT interval prolongation in experimental situations, but this has rarely been described in humans.
Objective: To describe a patient with heart failure and renal impairment who was receiving metoclopramide and developed prolonged QT and torsade de pointes.
Case Report: An 86-year-old man with a history of hypertension was admitted to the hospital after 6 weeks of shortness of breath. His history included gastroesophageal reflux disorder and hypothyroidism. His medications were l-thyroxine, metoclopramide, and lisinopril. On examination, he was in decompensated heart failure with an elevated jugular venous pulse, bibasilar rales, and …
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