Torsades de pointes is a polymorphic ventricular tachycardia that displays a unique electrocardiographic feature of twisting of the mean electrical axis of QRS complexes around an isoelectric line on the surface electrocardiogram. It is associated with long QT syndrome and has many precipitating mechanisms, etiologic factors, and treatment options. This report presents a case of torsades de pointes that was precipitated by multiple factors and required many treatment modalities. The patient in this case exhibited features of both congenital and acquired types of long QT syndrome.