Collapse on the cardiology ward

The case

68-year-old woman. Collapse on the cardiology ward

Admitted twelve days ago with an inferior STEMI treated with primary PCI to the right coronary artery. Started on sotalol 80 mg twice daily five days ago for recurrent non-sustained VT. Potassium was 4.1 mmol/L this morning. The nurse called the cardiac arrest team after the patient collapsed on the ward.

Stage 1 of 1

A 68-year-old woman is twelve days into her admission following an inferior STEMI. She was started on sotalol five days ago for recurrent non-sustained VT. Her potassium this morning was 4.1 mmol/L. The nurse calls the arrest team after the patient collapses. A twelve-lead ECG is recorded as the team arrives.

In the seconds before the collapse, the tracing shows sinus bradycardia. What interval abnormality is visible?

• AProlonged QT interval Correct answer Your answer
• BProlonged PR interval Your answer
• CWidened QRS complex Your answer
• DShortened QT interval Your answer

At the onset of the polymorphic ventricular tachycardia, a premature ventricular complex falls on the T wave of the preceding beat. What is this trigger mechanism called?

• AR-on-T phenomenon Correct answer Your answer
• BWenckebach phenomenon Your answer
• CBrugada sign Your answer
• DAshman phenomenon Your answer

Which drug on this patient's prescription prolongs the QT interval and is the most likely precipitant of the torsades?

• AAtorvastatin Your answer
• BTicagrelor Your answer
• CSotalol Correct answer Your answer
• DAspirin Your answer

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