Right Ventricular Outflow Tract PVCs and Long QT in a 22-Year-Old Female with COVID-19 and Concomitant Nirmatrelvir-Ritonavir and Fluoxetine Use

Case Report

Volume 5, Issue 4

Right Ventricular Outflow Tract PVCs and Long QT in a 22-Year-Old Female with COVID-19 and Concomitant Nirmatrelvir-Ritonavir and Fluoxetine Use

David Kim^1*, Alexander Sacher¹, Jasneel Kahlam², Stephen Poos², John Karstens² and Scott McGlynn^2,3

¹Department of Medicine, New York-Presbyterian Queens, Queens, NY, USA
²Department of Medicine, Stony Brook Southampton Hospital, Southampton, NY, USA
³Department of Cardiology, Stony Brook Southampton Hospital, Southampton, NY, USA

^*Corresponding author: David Kim, Department of Medicine, New York-Presbyterian Queens, Queens, NY, USA. E-mail: yvz9005@nyp.org

Received: October 19, 2025; Accepted: November 04, 2025; Published: November 15, 2025

Citation: Kim D, Sacher A, Kahlam J, et al. Right Ventricular Outflow Tract PVCs and Long QT in a 22-Year-Old Female with COVID-19 and Concomitant Nirmatrelvir-Ritonavir and Fluoxetine Use. Case Rep Clin Cardiol J. 2025; 5(4): 166.

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Right Ventricular Outflow Tract PVCs and Long QT in a 22-Year-Old Female with COVID-19 and Concomitant Nirmatrelvir-Ritonavir and Fluoxetine Use

Abstract

We present a case of a young woman who developed right ventricular outflow tract (RVOT) originating arrhythmias and QT prolongation following a COVID-19 infection and concomitant use of nirmatrelvir-ritonavir (Paxlovid) and fluoxetine. She was initially treated with mexiletine and ultimately received an implantable cardiac monitor. This case underscores the importance of evaluating medication interactions and their arrhythmogenic potential, especially in vulnerable populations, including those with a familial history of sudden cardiac death.

Keywords: RVOT PVC; Long QT; COVID-19; Paxlovid

Article Details

Right Ventricular Outflow Tract PVCs and Long QT in a 22-Year-Old Female with COVID-19 and Concomitant Nirmatrelvir-Ritonavir and Fluoxetine Use