Long QT Syndrome Unveiled by a Fatal Combination of Medications and Electrolyte Abnormalities

Abstract

Long QT syndrome (LQTS) can present with syncope and seizure-like activity in the setting of torsades de pointes (TdP) with hemodynamic instability. Electrolyte abnormalities and medications can predispose to TdP in the setting of latent LQTS. An implantable cardioverter defibrillator (ICD) is needed if patients with TdP continue to be symptomatic despite medical treatment. We report a case of a patient who presented with seizures and was found to have prolonged corrected QT interval (QTc). During her admission, she was treated with ondansetron. She went into torsades de pointes and continued to have prolonged QTc. She underwent implantable cardioverter defibrillator (ICD) placement and remains asymptomatic to date.

Acquired Long QT Syndrome (LQTS) Secondary to Electrolyte Imbalance: A Case Report

“…The long QT syndrome (LQTS) is a type of cardiac arrhythmia syndrome characterized with impaired ventricular repolarization manifest as prolongation of QT interval on the ECG [1,2]. This predisposes to the development risk of syncope, ventricular arrhythmias, seizure, and cardiac death to the patient [1,3,4].…”

“…Long QT syndrome incidences is approximately about 1 in 10.000 to 15.000 peoples and female is more prevalent [5]. Although there are many patients asymptomatic, the first clinical signs of this disease might be sudden cardiac death [1,2]. The following is a case report of 46-year-old women who came to the cardiology clinic with chief complaint of dizziness and diagnose with acquired LQTS secondary to electrolyte imbalance.…”

“…The long QT syndrome (LQTS) is serious cardiac arrhythmia disorder that driving reason of unexpected cardiac death, characterized with impaired ventricular repolarization manifest as prolongation of the QT interval on the electrocardiogram (ECG) [1,2]. This condition caused by hereditary disorder in sodium and potassium channels on cardiac myocyte and acquired caused by drugs or electrolyte imbalance, especially hypokalemia, hypomagnesemia, and hypocalcemia result in abnormality on the ECG examination as QT interval prolongation and may increase risk of syncope, ventricular arrhythmias, seizure, and cardiac death to the patient [1,3,4].…”