NOTES. FEEDBACK. Clinical features. o Palpitations. o Dizziness. o Syncope. o Cardiac arrest. FEEDBACK. Diagnostics. FEEDBACK. Treatment. FEEDBACK. Complications

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NOTES

FEEDBACK

Clinical features

· Often asymptomatic, especially if the QT interval is only minutely prolonged

· Some patients present with:

o Palpitations

o Dizziness

o Syncope

o Cardiac arrest

References: ^[5]

NOTES

FEEDBACK

Diagnostics

· Diagnosis of LQTS can be difficult because a slightly prolonged QT interval can be a normal variant (i. e., not congenital LQTS), and some patients with LQTS do not have a prolonged QT interval.

· The primary finding in LQTS is a long QT interval corrected for heart rate (QTc) interval.

o Males: > 440 ms

o Females: > 460 ms

· Other diagnostic criteria take patient history and ECG findings into account.

· Genetic testing confirms the diagnosis of LQTS.

References: ^[6][12]

NOTES

FEEDBACK

Treatment

· Both congenital and acquired LQTS

o Avoid activities that stress the heart

o Avoid cold temperatures (e. g., swimming, diving, skiing)

· Congenital LQTS

o First line: beta blockers (e. g., propranolol)

o Left cardiac sympathetic denervation (stellectomy): patients not responsive to beta blockers

o High-risk patients (recurrent syncope despite medical therapy, survival of cardiac arrest): implantable cardioverter defibrillator (ICD)

· Acquired LQTS: treat cause (remove offending drug, fix electrolyte imbalances, etc. )

All treatment modalities aim to reduce the risk and severity of cardiac events!

References: ^[6]

NOTES

FEEDBACK

Complications

· Ventricular tachycardia ( torsade de pointes )

· Ventricular fibrillation

· Asystole

· Sudden cardiac death

References: ^[13]

We list the most important complications. The selection is not exhaustive.

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