Unmasking Long QT Syndrome in the Emergency Department: A Case Report

Leslie, Eric; Medenbach, Andrew; Pittman, E.

doi:10.5811/cpcem.2020.10.48716

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…Comparing our case to similar ones, it is fair to conclude that the main nonmodifiable factor is genetic predisposition, with other modifiable elements that help provoke cardiac episodes being electrolytic imbalances or drugs affecting potassium ion channels [15,16]. Altough there are no reports about specific LQTS treatment, ß-blockers remains the top selection in relieving the symptoms and protection of life threatening arrythmias.…”

Section: Discussionmentioning

confidence: 48%

Unexpected Cause of Syncope in a 27 Year Old Patient: Case Report

Mierkytė,

Kireilis,

Ivanova

et al. 2024

Health Sciences

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Long QT syndrome (LQTS) is a rare inherited cardiac condition characterized by QT prolongation and T-wave abnormalities on the electrocardiogram (ECG). It is commonly associated with syncope, however, sudden cardiac death can occur due to Torsades de Pointes (TdP). We report the case of a 27-year-old female patient with genetically confirmed LQTS type 2 KCNH2 gene mutation found, who experienced multiple syncopes since a young age. After antipsychotic drugs were removed and ß-adrenoblockers were prescribed, fainting episodes did not reoccur.

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Section: Discussionmentioning

confidence: 48%

Unexpected Cause of Syncope in a 27 Year Old Patient: Case Report

Mierkytė,

Kireilis,

Ivanova

et al. 2024

Health Sciences

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“…The first was conducted to assess the cardiac events of asthmatic patients with LQTS undergoing beta-agonist treatment. The second was a double-blinded cross-over study done on eight subjects with bronchial asthma to determine the cardiac effect of beta-agonists [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Salbutamol-Induced QT Interval Prolongation in a Two-Year-Old Patient

Elgassim¹,

Abdelrahman²,

Saied³

et al. 2022

Cureus

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Salbutamol-induced QT interval prolongation is a relatively rare adverse effect of beta2-agonists. We report a case of a two-year-old female patient with no known past medical history, brought by her parents to the ED 30 minutes after ingesting a total dose of 97 mg of salbutamol solution. ECG was done for the patient when she arrived and showed sinus tachycardia with prolonged QTc (509 ms) and normal QRS complex. The patient was admitted to the Pediatric Intensive Care Unit (PICU) with persistent tachycardia and tachypnea in the initial reassessment. ECG was repeated with normal QT interval after IV Mg sulfate. The patient was observed in PICU for 12 hours with serial ECG and venous blood gas (VBG). IV potassium chloride (KCL) infusion started, and serial VBG showed normal potassium and lactate. The patient was doing well in the next six hours, with normal serial ECG, labs, and vital signs. In conclusion, salbutamol-induced QT prolongation has infrequently been reported in the literature. Although inhaled salbutamol is commonly used in clinical practice, physicians have limited experience with the severe features of its toxicity. Salbutamol is known to cause minimal side effects, which may be under-recognized and progress to serious manifestations such as hypokalemia, QT prolongation, and sudden cardiac death.

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Mechanical QT and JT intervals by M-mode echocardiography

Rad

Ilali

Majnoon

et al. 2022

Annals of Pediatric Cardiology

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Background : Congenital long QT syndrome (CLQTS) is a life-threatening ion channelopathy leading to syncope and sudden death. Early diagnosis during the prenatal period and timely intervention can prevent sudden cardiac death and catastrophic consequences of this genetic ion channelopathy. Fetal magnetocardiography and fetal electrocardiography (ECG) enable the measurement of fetal QT and JT intervals, but their inherently technically challenging and/or resource-intensiveness nature preclude their routine clinical application. On the other hand, the high-temporal resolution of M-mode echocardiography makes it a well-suited and widely available modality for the measurement of cardiac events. Aims and Objectives : We aimed to investigate the mechanical counterparts of the electrical QT and JT intervals on M-mode echocardiographic images of the tricuspid, mitral and aortic valves, and aortic wall. Methods : We performed a prospective study on consecutive children referred to the outpatient pediatric cardiology clinic at a tertiary children's hospital. We defined M-mode echocardiographic landmark points on tracings of tricuspid annular planar systolic excursion, mitral and aortic valves, and aortic wall with simultaneous electrocardiographic recording. We measured the mean±SD of the absolute time difference and RR-adjusted time difference in cases with non-coincident ECG events and echocardiographic landmarks. Results : Fifty healthy children were enrolled in the study. In 47 (94%) out of the 50 children, Q was coincident with the starting point of the tricuspid annular plane systolic excursion. In all children, the Q was coincident with the mid-point of the A-C line of the mitral valve. In 38 (76%) cases, there was a bump on the anterior wall of the aortic root immediately before the change in the slope of the aortic wall. This was coincident with the Q wave in 100% of cases. In all cases, the J point coincided with the point of acceleration of velocity on TAPSE. In all children, the J point coincided with the initial maximal opening of the aortic cusps. The end of the T wave occurred coincident with the peak of the tricuspid annular planar systolic excursion in 47 children (94%). In 48 children (96%), the end of the T wave coincided with the aortic cusps' closure point. Conclusions : Based on our findings, we propose to measure the averaged mechanical QT and JT intervals by using an angled M-mode tracing of the aortic and mitral valve in five consecutive beats in the parasternal long-axis view. This is the first study on mechanical QT and JT intervals in healthy children. The study opens the horizons into the in-utero diagnosis of congenital long QT syndrome by measuring fetal QT and JT intervals using the widely available M-mode echocardiography

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Unmasking Long QT Syndrome in the Emergency Department: A Case Report

Cited by 3 publications

References 13 publications

Unexpected Cause of Syncope in a 27 Year Old Patient: Case Report

Unexpected Cause of Syncope in a 27 Year Old Patient: Case Report

Salbutamol-Induced QT Interval Prolongation in a Two-Year-Old Patient

Mechanical QT and JT intervals by M-mode echocardiography

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