Torsades de Pointes is described as

• A. Smooth, uniform QRS complexes.
• B. Corkscrew appearance and prolonged QTc.
• C. Narrow QRS with upright P waves.
• D. Monomorphic, regular VT.

Answer: (B)

Torsades de Pointes is a polymorphic ventricular tachycardia that occurs when the QT interval is prolonged. The key visual cue on the ECG is a twisting, corkscrew pattern of the QRS complexes as they appear to rotate around the baseline. This happens because the extended repolarization phase makes the ventricles more susceptible to afterdepolarizations that trigger beats at varying times, changing the direction and amplitude of the QRS with each beat.

So the corkscrew appearance paired with a prolonged QT interval is the hallmark of torsades de Pointes. The other descriptions fit different ECG patterns: smooth, uniform QRS complexes describe a uniform, monomorphic rhythm; narrow QRS with upright P waves points to normal sinus rhythm or a non-ventricular origin; monomorphic, regular VT is a single-shaped (non-twisting) ventricular tachycardia.