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Hypothyroidism can manifest with cardiac abnormalities, often consisting of a combination of morphologic and functional changes. Low voltage, sinus bradycardia, and slowed conduction are usually found on electrocardiography.

There are few reports of occurrence of torsades de pointes as the first presentation of long QT syndrome in the course of hypothyroidism.

In present report we briefly describe a 50-years-old woman with severe hypothyroidism who presented with presyncope, prolongation of the QT interval, and polymorphic ventricular tachycardia (torsades de pointes).

Our patient responded well to treatment with levothyroxine and QT intervals normalized and ventricular tachycardia was abolished two months after levothyroxine therapy.