Background: Prolongation of the QT interval is associated with adverse cardiac events, mainly a distinctive ventricular tachycardia known as Torsades de Pointes. Prolonged QT can be congenital or acquired and is OFTEN measured as a corrected QT interval of >450 msec for men and >470 msec for women. In a world where medical knowledge and [...]

Background: Antipsychotics are frequently used in the hospital setting for managing both acute and chronic neuropsychiatric disorders. However, antipsychotics have been associated with higher rates of adverse events, including mortality, due to their association with QT prolongation, which can lead to fatal cardiac arrhythmias such as torsade de pointes, earning a black box warning for use in dementia related psychosis. Yet, [...]

Background: Drug induced long QT syndrome is quite common in daily clinical practice but its impact is unknown. Methods: We searched the PubMed and EMBASE databases (until May 2nd, 2017) to identify studies reporting drug induced Long QT syndrome and followed the PRISMA guidelines. The main outcomes measured in these studies were QTc prolongation, Ventricular [...]

Background: Antipsychotics are frequently used in the hospital setting for managing both acute and chronic psychiatric disorders. However, antipsychotics have been associated with higher rates of mortality due to their cardiovascular risk factors, such as QT prolongation. This study aimed to determine the association between cumulative dose of antipsychotics (first and second-generation) and QT prolongation, [...]

Background: It is common practice to monitor QTc interval in hospitalized patients newly started on antipsychotics. While some guidelines exist for frequency of ordering EKGs in the outpatient setting, these may not apply to inpatients due to comorbid electrolyte disturbances or addition of other new medications. There are no evidence-based guidelines for QTc monitoring frequency [...]

Background: Antipsychotics can prolong QTc interval and lead to development of the fatal arrhythmia Torsade de Pointes. Accordingly, serial EKG monitoring of QTc in patients newly started on antipsychotics has become common practice in hospitals. By current standards, medical management of antipsychotic therapy is clinically indicated when QTc > 500ms and/or there is an increase [...]

Background: Hospital readmissions within 30 days of discharge have gained national attention and account for more than $17 billion in avoidable U.S. Medicare expenditures each year. (1) In 2011 alone, there were approximately 3.3 million adult 30-day all-cause hospital readmissions, costing the US $41.3 billion.(2) As such, efforts have been made to create algorithms to [...]

Case Presentation: A 24 year-old male presented with chest pain and a diarrheal illness. He complained of intermittent chest pains which began two weeks prior, described as retrosternal, aggravated by lying down and improving on sitting up. One week following this, he started experiencing fevers, chills along with nausea, vomiting and diarrhea. Given persistent high [...]

Case Presentation: A 37 year-old woman with a past medical history of depression and chronic knee pain presented with complaints of two day duration non-radiating 8/10 epigastric and lower abdominal pain associated with nausea and vomiting. Vitals sings were normal. Abdomen was soft, non-distended with generalized tenderness, but without masses, rebound, or guarding. Lipase was [...]

Case Presentation: A 35-year-old female presented to the emergency department after an episode of syncope. She takes methadone (180 mg/day) for opioid dependency. She had a recent relapse and returned to illicit drug use after a period of sobriety. Vital signs were notable for tachycardia, blood pressure and respiratory rate were normal. On physical exam [...]