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And of course Ken's comments at the bottom) An elderly obese woman with cardiomyopathy, Left bundle branch block, and chronic hypercapnea presented hypoxic with altered mental status. I do not see OMI here and all trops were only minimally elevated, consistent with either chronic injury from cardiomyopathy or with acute injury from sepsis.
Had there been recurrent episodes of pause-dependent TdP, temporary ventricular pacing at a higher heart rate would have been indicated to suppress the pauses and in that way decreasing the risk of further episodes of TdP. A coronaryangiogram was done that did not show significant coronary artery disease.
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