It should be the longest QT interval of all 12 leads, and this is the way most computer algorithms measure it. The QT is the interval from the beginning of the QRS to the end of the T-wave.
#NORMAL QT INTERVAL MANUAL#
He was given Magnesium, Calcium, and Potassium, monitored in the ICU, and the eventually the ECG corrected as the drugs metabolized.Īn echocardiogram showed no wall motion abnormality and the elevated troponin was not thought to be due to a Type 1 MI in this critically ill patient.Ĭomment: computer and manual QT measurementĬomputer algorithms for measure the QT interval are good for normal QT intervals but not for long QT intervals, and are particularly inaccurate for very long QT intervals. This is a very dangerously long acquired long QT, and is due to a combination of azithromycin, haloperidol, hypokalemia, and hypocalcemia (note the long ST segments which are typical of hypocalcemia). The computer read the QT as 450 ms when it is really around 700 ms. There is now sinus bradycardia with a bizarrely long QT interval. Magnesium was 1.5 mEq/L (normal, 1.3 - 2.0)Ī troponin returned slightly elevated, so another ECG was recorded: His K returned at 2.8 mEq/L and ionized Calcium at 3.82 mEq/L (normal, 4.4 -5.2). Then he became very agitated in spite of correction of hypoglycemia, and was given a total of 15 mg of haloperidol. He received azithromycin and ceftriaxone for community acquired pneumonia. Sinus rhythm with slight right axis deviation and non-diagnostic T-wave inversions He was hypoglycemic (mild, 45 mg/dl) and had pneumonia with hypoxia. A middle-aged male with h/o DM was found down.
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