She denied any history of palpitations, syncope, or pre-syncope. Her vital signs included heart rate (HR) of 80 bpm, blood pressure of 135/76 mm Hg, and respirations of 12 per minute. In the cardiology clinic, she appeared comfortable and was without complaints. Given that nilotinib has a black box warning issued by the Food and Drug Administration for QT interval prolongation, she was referred to the cardiology clinic for further evaluation. Prior to initiating nilotinib, a baseline ECG was obtained that demonstrated a QTc of 505 ms using Bazett's formula. As such, her oncology team was interested in starting nilotinib, a different tyrosine kinase inhibitor as second-line therapy to control her cancer. However, she demonstrated progression of disease while on this agent. She was initially treated with imatinib, a tyrosine kinase inhibitor. She was diagnosed with chronic myelogenous leukemia approximately 1 year prior to presentation. A 55-year-old woman with a past medical history of hypertension, mild depression, and chronic myelogenous leukemia is referred to cardiology clinic for evaluation of an abnormal electrocardiogram (ECG).
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