When translators come across the term “Torsades de pointes” in a French text, they instinctively want to translate it into English to make this complex term and rare ECG finding more accessible to an English-speaking audience. While we are used to seeing borrowed English terms in foreign texts (particularly in scientific and technical texts), the reverse is far less common, especially in the life sciences. However, renderings of the term in English, such as “twisting of peaks” or “twisting of points”, are incorrect, since the standard English term is indeed “torsades de pointes”, often shortened by physicians to “torsades” or “TdP” to get around the tricky French pronunciation.
Torsades de pointes
The term coined by French physician François Dessertenne in 1966 reminded the doctor of the pirouettes performed en pointe in classical ballet.
However, multilingual translators beware: while English borrows the French term without translation, usage in other languages varies. Spanish and Portuguese also borrow the French torsades de pointes, while Italian literally translates the term and makes it singular (torsione di punta), Arabic transliterates the French (تورساد دي بوانت), and the Russian translation (пируэтная тахикардия) “pirouette tachycardia"” elegantly reflects the ballet-inspired etymology of the term.
Torsades is characterised by a gradual change in the amplitude and the twisting of the QRS complexes around the isoelectric line. The distinct ECG tracing looks like a ribbon or party streamer.
Torsades de pointes literally means “twisting of points” in French and refers to a specific, rare variety of ventricular tachycardia (disturbance of the heart’s rhythm) that exhibits distinct characteristics on the electrocardiogram (ECG). Torsades is a type of disturbance in the heart’s rhythm, called arrhythmias. When the heart beats faster than usual, this is called tachycardia. Ventricular tachycardia (VT) is a fast, abnormal heart rate that starts in the heart’s lower chambers, or ventricles. VT occurs when three or more heartbeats in a row occur at a rate greater than 100 beats per minute. Torsades is a rare and specific type of polymorphic (when the shapes on the ECG vary continuously) VT when the heart’s ventricles beat faster than the upper chambers, or atria. Most cases of torsades resolve on their own without treatment. However, it can develop into ventricular fibrillation, which can lead to cardiac arrest and sudden cardiac death.
Torsades is a rare condition and can be a complication of a heart attack or can occur in people with certain conditions, such as valvular heart disease or hypomagnesium. Symptoms include chest pain, fainting, dizziness, shortness of breath, hypotension, and palpitations. Immediate treatment is required with options that include medication to slow the heart rate, surgery, and an implantable device. Torsades is also commonly found in patients who are chronic alcoholics and who are poorly nourished. A lack of magnesium (hypomagesnium) is usually the cause in cases of chronic alcoholism. In such cases, treatment is directed at correcting the cause.
Interested in learning more about torsades de pointes and all the specifics of the ECG tracing? Check out this video from Ninja Nerd Lectures, as well as their entire ECG playlist.
