Resumo

DUQUE, Laura et al. Glucantime and QTc interval prolongation: A fatal combination. CES Med. [online]. 2019, vol.33, n.3, pp.201-207. ISSN 0120-8705.  https://doi.org/10.21615/cesmedicina.33.3.5.

Cutaneous leishmaniasis is a disease caused by an intracellular protozoan parasite; Glucantime is a therapeutic option, although it is associated with cardiovascular alterations, the most frequent being the prolongation of the QTc interval, that occurs between 17.8% and 19% of patients. If this effect is not early recognized, it can cause a fatal arrhythmia due to torsade de pointes. The case of a 77-year-old patient who was receiving intramuscu lar glucantime as treatment for cutaneous leishmaniasis is presented, the patient was admitted with severe refractory hypokalemia and episodes of torsade de pointes; subsequently, presented ventricular fibrillation that did not respond to defibrillation and resuscitation. The alterations in cardiac repolarization produced by this medicine are considered secondary to the accumulation of pentavalent and trivalent compounds in the myocardium. There is no specific treatment for this situation, but supportive manage ment should always be performed, avoid drugs that prolong the QT inter val, normalize potassium and magnesium levels, raise the heart rate with isoproterenol and implant transvenous pacemaker to achieve over-stimulation and reduction of refractory periods.

Palavras-chave : Long-QT syndrome; Tachycardia; Torsade de pointes; Glucantime; Major cardiovascular events.

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