Metoclopramide as a Possible Cause of Prolonged QT Syndrome and Torsade de Pointes in a Patient With Heart Failure and Renal Insufficiency

Letters7 April 2009Metoclopramide as a Possible Cause of Prolonged QT Syndrome and Torsade de Pointes in a Patient With Heart Failure and Renal InsufficiencySultan M. Siddique, MD, Nasir Shariff, MD, Nimesh Vesuwala, MD, and Tariq Hafiz, MDSultan M. Siddique, MDFrom Lehigh Valley Hospital, Allentown, PA 18104; Pottsville Hospital, Pottsville, PA 17901; and Pottsville Internist Associates, Pottsville, PA 17901., Nasir Shariff, MDFrom Lehigh Valley Hospital, Allentown, PA 18104; Pottsville Hospital, Pottsville, PA 17901; and Pottsville Internist Associates, Pottsville, PA 17901., Nimesh Vesuwala, MDFrom Lehigh Valley Hospital, Allentown, PA 18104; Pottsville Hospital, Pottsville, PA 17901; and Pottsville Internist Associates, Pottsville, PA 17901., and Tariq Hafiz, MDFrom Lehigh Valley Hospital, Allentown, PA 18104; Pottsville Hospital, Pottsville, PA 17901; and Pottsville Internist Associates, Pottsville, PA 17901.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-7-200904070-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail 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 ...References1. Roden DM. Drug-induced prolongation of the QT interval. N Engl J Med. 2004;350:1013-22. [PMID: 14999113] CrossrefMedlineGoogle Scholar2. Claassen S, Zünkler BJ. Comparison of the effects of metoclopramide and domperidone on HERG channels. Pharmacology. 2005;74:31-6. [PMID: 15640612] CrossrefMedlineGoogle Scholar3. Chou CC, Wu D. Torsade de pointes induced by metoclopramide in an elderly woman with preexisting complete left bundle branch block. Chang Gung Med J. 2001;24:805-9. [PMID: 11858397] MedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Sultan M. Siddique, MD; Nasir Shariff, MD; Nimesh Vesuwala, MD; Tariq Hafiz, MDAffiliations: From Lehigh Valley Hospital, Allentown, PA 18104; Pottsville Hospital, Pottsville, PA 17901; and Pottsville Internist Associates, Pottsville, PA 17901.Disclosures: None disclosed. 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