Several psychiatric medications prolong the QTC interval and place patients at risk of the dreaded

torsade de point. Some patients are particularly vulnerable to QTC prolongation. The elderly,

patients with heart disease, and electrolyte imbalance, and patients taking certain medications like

thyroidazine and zeprazadone. In this podcast, we'll

provide a step-by-step guide so that you can keep your patients safe from this cardiovascular side

effect. Welcome to the Carlatte Psychiatry podcast. This is a special episode from the Carlat Hospital Psychiatry Report.

I'm Dr. Victoria Hendrick, the editor-in-chief of the Carlat Hospital Psychiatry Report,

and a clinical professor at the David Geffen School of Medicine at UCLA.

I'm also the director of inpatient psychiatry at all of you UCLA Medical Center.

And I'm ProBJat Gail. I'm the podcast content coordinator at Carlop Publishing, and I will also

be attending graduate school this year to receive my doctor in psychology. Let's begin by discussing

what exactly QT interval prolongation is and why it's so concerning.

The QT interval represents the time it takes for the heart ventricles to contract and relax.

Since heart rate variations affect this measurement,

clinicians typically look at QTC intervals, where the C stands for corrective.

Normal QTC intervals are less than 430 milliseconds for men and less than 450 milliseconds for women. We worry about prolonged

QTC intervals because they increase the risk of abnormal heart rhythms like Tursad de Point.

Translating to twisting of the points,

Tursad is a form of ventricular tachycardia in which the QRS complexes appear to twist around

the isoelectric line. Most cases terminate spontaneously, but some progress to potentially

deadly ventricular fibrillation. The risk of Torsad increases several-fold with

QTC intervals greater than 500 milliseconds. Patients most at risk are those over the age of 65,

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