Very abnormal T waves in a 37-year-old man

Willcox, Mark E.; Kudenchuk, Peter J.; Prutkin, Jordan M.

doi:10.1136/heartjnl-2015-308318

Cited by 2 publications

(2 citation statements)

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“…41 T-wave alternans often precedes TdP and indicates electrical instability assisting in the identification of high-risk patients who may require review and reassessment of therapy. 22,25 …”

Section: Electrocardiographic Aspects Of Lqtsmentioning

confidence: 99%

“…25,42 T-wave alternans (Figure 6), characterized by beat-to-beat variability in polarity or amplitude of the T-wave, may be present at rest for brief moments but usually appears during emotional or physical stress or with QT-prolonging medications. 41 T-wave alternans often precedes TdP and indicates electrical instability assisting in the identification of high-risk patients who may require review and reassessment of therapy. 22,25…”

Section: Electrocardiographic Aspects Of Lqtsmentioning

confidence: 99%

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Evaluation and Management of Athletes With Long QT Syndrome

Gomez

Prutkin

Rao

2016

Sports Health: A Multidisciplinary Approach

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Context:The congenital long QT syndrome (LQTS) is an inherited channelopathy known for its electrocardiographic manifestations of QT prolongation and its hallmark arrhythmia, torsades de pointes (TdP). TdP can lead to syncope or sudden death and is often precipitated by triggers such as physical exertion or emotional stress. Given that athletes may be at particular risk for adverse outcomes, those suspected of having LQTS should be evaluated, risk stratified, treated, and receive appropriate counseling by providers with sufficient expertise according to the latest guidelines.Evidence Acquisition:The following keywords were used to query MEDLINE and PubMed through 2016: LQTS, LQT1, LQT2, LQT3, long QT, long QTc, prolonged QT, prolonged QTc, QT interval, QTc interval, channelopathy, channelopathies, athletes, torsades de pointes, and sudden cardiac death. Selected articles within this primary search, in addition to relevant references from those articles, were reviewed for relevant information and data. Articles with pertinent information regarding pathophysiology, evaluation, diagnosis, genetic testing, treatment, and guidelines for athletes were included, particularly those published in the prior 2 decades.Study Design:Clinical review.Level of Evidence:Level 3.Results:Diagnosis of LQTS involves eliciting the patient’s family history, clinical history, and evaluation of electrocardiographic findings. Genetic testing for common mutations can confirm suspected cases. β-Blockers represent the mainstay of treatment, though interventions such as implantable cardioverter-defibrillator placement or left cardiac sympathetic denervation may be required. Properly evaluated and treated athletes with LQTS have a low risk of cardiac events.Conclusion:Detection and management of LQTS in the athletic population is crucial given the possibility of adverse outcomes with the stress of athletic participation. Preparticipation screening examinations should include a thorough clinical and family history. Screening electrocardiograms may display key findings consistent with LQTS while genetic testing can confirm the diagnosis. Formerly considered a strict contraindication to athletic participation, LQTS is now an increasingly manageable entity with proper evaluation and treatment by qualified and experienced providers.

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Section: Electrocardiographic Aspects Of Lqtsmentioning

confidence: 99%