Individuals suffering from torsades de pointes suffer recurrent palpitation events, syncope and dizziness. In addition to this, patients also experience shortness of breath, difficulty in breathing, pain in chest and nausea accompanied by cold sweats. In many instances sudden death can occur due to cardiac arrest.
Research has also shown that period of stress, fear, anxiety or physical exertion can trigger episodes of torsades. Patients may also exhibit signs of rapid pulse rate, and transient periods of unconsciousness. Other physical symptoms would depend on the type of congenital disorder present. Individuals who experience sustained episodes of torsades may suffer from diaphoresis and pallor.
Making an appropriate diagnosis of torsades de pointes is necessary to separate the condition from other variants of ventricular tachycardia. Failure to promptly diagnose the condition can lead to continuation of rhythm disturbances. Diagnosis of torsades de pointes includes the following tests:
The condition resolves almost spontaneously; however can recur until the underlying etiology is completely treated. In untreated cases, or if there is a delay in initiation of treatment, there are chances of patients falling prey to sudden death. If the prolonged QT interval is acquired in nature, the prognosis is excellent, with correction of precipitating factor .
In many cases prolonged QT interval may be a congenital affair. Individuals with Jervell and Lange-Nielson syndrome and Romano Ward syndrome are likely to exhibit prolonged QT interval. These syndromes are associated with sudden death either due to primary onset of ventricular fibrillation or induced ventricular fibrillation due to torsades.
Electrolyte imbalances can predispose an individual to develop torsades de pointes. Certain drugs such as tricyclic antidepressants, cisapride, high-dose methadone, lithium carbonate, ziprasidone and chemotherapeutic agents can also increase the likelihood of prolonging QT interval  .
The exact incidence of torsades de pointes is unknown. It has been estimated that, women are 3 to 4 times more likely to have prolonged QT intervals. In addition, women also are at an increased risk of secondary development of torsades de pointes in response to drugs .
Torsades de pointes increases the risk of sudden death and it has been reported that about 300,000 sudden deaths occur in US every year. Of these, 5% of the cases occur due to torsades. Individuals in the age group of 35 to 50 years are more prone to suffer from prolonged QT interval .
The major and basic phenomenon behind the onset of lengthened QT interval in individuals is the current flow which is ionic in nature and that takes place during the repolarization phase. The morphology of QRS complex is different with each heart beat; however, the electrocardiogram appears like twisted ribbons, which is characteristic of torsades de pointes .
The appearance of twisted ribbons in electrocardiogram can be attributed to lengthened QT intervals which is the resultant reaction of delayed depolarization phase. This is considered to be the most vulnerable period, wherein majority of the myocardial tissue is ready to accept signals .
Individuals are advised to avoid those drugs that can lengthen the QT interval. Individuals with family history of torsades de pointes are at an increased risk of contracting the condition and therefore such families should be regularly screened. Certain predisposing factors such as hypomagnesemia, hypocalcemia and hypokalemia should be prevented.
Torsades de pointes is a type of ventricular tachycardia which may eventually resolve on its own; but can recur increasing the risk for other conditions. The ventricular heart rate in torsades de pointes is recorded to be 150 to 250 beats per minute. The condition is distinctly different from other forms of ventricular tachycardia due to its morphological characteristics, underlying etiology and types of therapy .