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Recognizing Long QT Syndrome in Patients ___Long QT syndrome often goes unnoticed in patients because it rarely presents easily recognizable symptoms. It is generally discovered in a patient following a long QT induced event, such as a seizure or syncopal episode. However, as high as 40% of people diagnosed with long QT syndrome are asymptomatic at the time of their diagnosis.___For the physician, there are three key steps to dealing with a patient who is suspected of having long QT syndrome. First, an interview and analysis of the patient's medical history needs to be conducted. Second, if any signs or symptoms of long QT syndrome are revealed, the patient should be given a 12-lead electrocardiogram (EKG/ECG) to determine the value of their corrected QT interval (QTc). Third, if a patient's QTc is above its normal range, they must be immediately referred to a cardiologist to obtain treatment. ___The interview is an important time to gather detailed information about a patient's medical background and family history. Key points to discuss with the patient during the interview include whether or not they have ever experienced any of the symptoms associated with long QT syndrome, used a QT prolonging drug, and if they have any family members who may be symptomatic for long QT syndrome.  ___The "Long QT Checklist" is an excellent tool to aide in interviewing patients who are suspected of having long QT syndrome. The checklist consists of ten simple questions that are targeted at identifying whether or not the patient or any of their direct relatives may have long QT syndrome. If during the interview the patient answers "Yes" to any of the checklist's questions, it is strongly recommended that a 12-lead EKG be given to the patient to obtain their QTc measurement. The significance of the QTc measurement and its role in diagnosing long QT syndrome are discussed within the EKG Analysis section of this website.Click here to download the Long QT Checklist in Adobe Acrobat format (*.pdf). ___During the interview, information about any drugs that the patient was using within a month of any symptomatic events needs to be recorded. This includes all over-the-counter, prescription, and illegal drugs that the patient may have been using. Remember to check the patient's medical records for any drugs they have been prescribed.  The drugs that the patient has used should be compared to the list of "QT Drugs to Avoid". If it is noted that they had been using a drug on the QT Drugs to Avoid list, the patient's current QTc should be evaluated. If the QTc appears within normal values (see EKG Analysis section) the patient should be considered as a suspect for having the acquired form of long QT syndrome. In order to obtain the proper diagnosis, the patient will need to be referred to either a cardiologist or electrophysiologist who can perform an epinephrine or dobutamine test on the patient to determine if the patient has the acquired form of long QT syndrome.Click here to download the QT Drugs to Avoid list in Adobe Acrobat format (*.pdf). ___If after interviewing and reviewing a patient's medical records there are any reasons to suspect that a patient may have long QT syndrome, a 12-lead EKG needs to be performed on the patient. Since over 75% of long QT syndrome carriers are identified through EKG analysis, it is critical that their EKG be evaluated properly. For information on analyzing a patient's EKG and determining their QTc, please visit the EKG analysis section of our website by clicking here.  ___ The contents of the Long-QT-Syndrome.com Site, such as text, graphics, images and all other material contained on Long-QT-Syndrome.com are for informational purposes only. The contents were not written by a practicing medical doctor/physician and may not be correct. The content within Long-QT-Syndrome.com is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Long-QT-Syndrome.com Site! |
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