Long QT syndrome: Difference between revisions

	Long QT Syndrome Microchapters
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	Long QT syndrome;
	Type 3 Long QT Syndrome
ICD-10	I45.8
ICD-9	426.82
DiseasesDB	11104
MeSH	D008133

VisualWikitext

Latest revision as of 17:36, 10 March 2020

For patient information, click here.

Long QT syndrome is one of the many causes of QT prolongation. For a complete review of QT prolongation in general, click here.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Synonyms and keywords: LQTS; long QT; congenital long QT; congenital long QT interval

Overview

Historical Perspective

Classification

Pathophysiology

Differentiating Long QT Syndrome from other Diseases

Epidemiology and Demographics

Risk Stratification

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Electrocardiogram | Genetic Studies | Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Contraindicated medications

Long QT syndrome is considered an absolute contraindication to the use of the following medications:

Dofetilide

Case Studies

Case #1

Related Chapters

Template:WikiDoc Sources

@@ Line 2: / Line 2: @@
 {{Infobox_Disease |
    Name           = Long QT syndrome |
-   Image          = SinusRhythmLabels.png |
+   Image          =Long QT Syndrome.PNG|
-   Caption        = Schematic representation of normal ECG trace ''([[sinus rhythm]]),'' with waves, segments, and intervals labeled. |
+   Caption        = Type 3 Long QT Syndrome |
    DiseasesDB     = 11104 |
    ICD10          = {{ICD10|I|45|8|i|30}} |
@@ Line 10: / Line 10: @@
    OMIM           = |
    MedlinePlus    = |
-  eMedicineSubj  = |
-  eMedicineTopic = |
    MeshID         = D008133 |
 }}
 {{Long QT Syndrome}}
-{{WikiDoc Cardiology Network Infobox}}
-{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}}
+'''For patient information, click [[Long QT syndrome (patient information)|here]].'''
-==Treatment options==
+'''Long QT syndrome is one of the many causes of [[QT prolongation]]. For a complete review of [[QT prolongation]] in general, click [[QT prolongation|here]].'''
-There are two treatment options in individuals with LQTS: arrhythmia prevention, and arrhythmia termination.
-===Arrhythmia prevention===
+{{CMG}}
-Arrhythmia suppression involves the use of medications or surgical procedures that attack the underlying cause of the arrhythmias associated with LQTS.  Since the cause of arrhythmias in LQTS is after depolarizations, and these after depolarizations are increased in states of adrenergic stimulation, steps can be taken to blunt adrenergic stimulation in these individuals.  These include:
-* Administration of [[beta blocker|beta receptor blocking agents]] which decreases the risk of stress induced arrhythmias. Beta blockers are the first choice in treating Long QT syndrome.
-In 2004 it has been shown that genotype and QT interval duration are independent predictors of recurrence of life-threatening events during beta-blockers therapy. Specifically the presence of QTc >500ms and LQT2 and LQT3 genotype are associated with the highest incidence of recurrence. In these patients primary prevention with ICD (Implantable Cardioverster Defibrilator) implantaion can be considered.<ref>Priori SG, Napolitano C, Schwartz PJ, Grillo M, Bloise R, Ronchetti E, Moncalvo C, Tulipani C, Veia A, Bottelli G, Nastoli J. Association of long QT syndrome loci and cardiac events among patients treated
+{{SK}} LQTS; long QT; congenital long QT; congenital long QT interval
-with beta-blockers. JAMA. 2004 Sep 15;292(11):1341-4. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15367556&query_hl=26&itool=pubmed_docsum PMID: 15367556]</ref>
-* Potassium supplementation. If the potassium content in the blood rises, the action potential shortens and due to this reason it is believed that increasing potassium concentration could minimize the occurrence of arrhythmias. It should work best in LQT2 since the HERG channel is especially sensible to potassium concentration, but the use is experimental and not evidence based.
+== [[Long QT Syndrome overview|Overview]] ==
-* [[Mexiletine]]. A sodium channel blocker. In LQT3 the problem is that the sodium channel does not close properly. Mexiletine closes these channels and is believed to be usable when other therapies fail. It should be especially effective in LQT3 but there is no evidence based documentation.
-* Amputation of the [[cervical sympathetic chain]] (left [[Stellate ganglion|stellectomy]]). This may be used as an add-on therapy to beta blockers but modern therapy mostly favors ICD implantation if beta blocker therapy fails.
-===Arrhythmia termination===
+== [[Long QT Syndrome historical perspective|Historical Perspective]]==
-Arrhythmia termination involves stopping a life-threatening arrhythmia once it has already occurred.  The only effective form of arrhythmia termination in individuals with LQTS is placement of an [[implantable cardioverter-defibrillator]] (ICD). ICD are commonly used in patients with syncopes despite beta blocker therapy, and in patients who have experienced a cardiac arrest.
-With better knowledge of the genetics underlying the long QT syndrome, more precise treatments will be readily available.<ref>Compton SJ, Lux RL, Ramsey MR, Strelich KR, Sanguinetti MC, Green LS, Keating MT, Mason JW. Genetically defined therapy of inherited long-QT syndrome. Correction of abnormal repolarization by potassium. Circulation. 1996 Sep 1;94(5):1018-22. PMID 8790040</ref>
+== [[Long QT Syndrome classification|Classification]] ==
-==References==
+== [[Long QT Syndrome pathophysiology|Pathophysiology]] ==
-<references/>
-==See also==
+== [[Long QT Syndrome differential diagnosis|Differentiating Long QT Syndrome from other Diseases]] ==
+== [[Long QT Syndrome epidemiology and demographics|Epidemiology and Demographics]]==
+== [[Long QT Syndrome risk stratification|Risk Stratification]] ==
+== [[Long QT Syndrome screening|Screening]]==
+== [[Long QT Syndrome natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==
+== Diagnosis ==
+[[Long QT Syndrome history and symptoms|History and Symptoms]] | [[Long QT Syndrome electrocardiogram|Electrocardiogram]] | [[Long QT Syndrome genetic studies|Genetic Studies]] | [[Long QT Syndrome other diagnostic studies|Other Diagnostic Studies]]
+== Treatment ==
+===Medical Therapy===
+===Surgery===
+===Primary Prevention===
+===Secondary Prevention===
+====Contraindicated medications====
+{{MedCondContrAbs|MedCond = Long QT syndrome|Dofetilide}}
+==Case Studies==
+:[[Long QT Syndrome case study one|Case #1]]
+==Related Chapters==
 * [[Cardiac action potential]]
 * [[Short QT syndrome]]
-==External links==
-* [http://videos.med.wisc.edu/videoInfo.php?videoid=266 VIDEO - Mechanistic Insight into a Rare Cardiovascular Disease: Congenital Long QT Syndrome 2007]
-* {{DMOZ|Health/Conditions_and_Diseases/Cardiovascular_Disorders/Heart_Disease/Arrhythmia/Long_QT_Syndrome/}}
 {{Electrocardiography}}
@@ Line 54: / Line 67: @@
+[[Category:Best pages]]
 [[Category:Cardiology]]
 [[Category:Electrophysiology]]

v t e Electrocardiography
Overview	History of the EKG • EKG interpretation basics • Normal sinus rhythm
EKG Complexes	P wave • QRS complex • ST Segment • T wave • T wave alternans • Tombstone T wave • U wave Osborn wave • H wave • K wave • Delta wave NSSTW changes
EKG Intervals	PR Interval • QRS Interval • ST Interval • QT Interval
Conduction System & Bradycardia	Cardiac pacemaker • SA node • AV node• Bundle of His • Purkinje fibers • Sinus bradycardia • First Degree AV Block • Second Degree AV Block • Complete or Third-Degree AV Block • Concealed conduction • AV Junctional Rhythms • LBBB • LAHB • LPHB • RBBB • Trifascicular block
Atrial Arrhythmias	Sinus tachycardia • Premature Atrial Contractions (PACs) • Ectopic Atrial Rhythm • Paroxysmal Atrial Tachycardia (PAT) • Paroxysmal Atrial Tachycardia (PAT) with Block • Multifocal Atrial Tachycardia (MAT) • Atrial Flutter • Atrial Fibrillation • Wandering atrial pacemaker
Ventricular Arrhythmias	Differential Diagnosis of Tachycardia with a Wide QRS Complex • Accelerated Idioventricular Rhythm • Ventricular Parasystole • Premature Ventricular Contractions (PVCs) • Ventricular tachycardia • Ventricular Fibrillation • Sudden cardiac death
EKG Abnormalities in Disease States	Hypertrophy & Dilatation • Right atrial enlargement • Left atrial enlargement • Biatrial enlargement • Left Ventricular Hypertrophy • Right Ventricular Hypertrophy • Biventricular Hypertrophy • Acute myocardial infarction • NSTEMI • STEMI • Tombstone ST elevation • Right ventricular myocardial infarction • Atrial infarction Pre-excitation Syndromes • Wolff-Parkinson-White Syndrome • Lown Ganong Levine Syndrome • Mahaim Type Preexcitation Cardiomyopathies • Arrhythmogenic Right Ventricular Dysplasia • Dilated Cardiomyopathy • Hypertrophic Cardiomyopathy Drug Effects on the EKG • Adenosine • β-blockers • Digitalis • Quinidine • Procainamide • Disopyramide • Lidocaine • Tocainide and Mexiletine • Phenytoin • Encainide, Flecainide and Propafenone • Amiodarone • Bretylium • Ca Channel Blockers • Phenothiazines • Tricyclic Antidepressants • Lithium Congenital Heart Disease • Dextrocardia • Atrial Septal Defect • Ventricular Septal Defect • Tetralogy of Fallot • Conjoined Twins or Siamese Twins • Congenital heart block Electrolyte Disturbances • Hyperkalemia • Hypokalemia • Hypercalcemia • Hypocalcemia • Nonspecific Changes Other Heart Diseases • Pericarditis • Myocarditis • Tamponade • Heart Transplantation • Sick Sinus Syndrome • Long QT Syndrome Inherited Disease • Brugada Syndrome Systemic Diseases • CNS Disease • Cardiac Tumors Heart Transplantation • EKG Changes in patient with Heart Transplantation Exogenous Effects • Hypothermia • Chest Trauma • Insect Bites • Electric Injuries
Technical Issues and Potential Errors in Interpretation	Artifacts • Lead Placement Errors • The EKG in a Patient with a Pacemaker • EKG in athletes


Long QT syndrome
Type 3 Long QT Syndrome
ICD-10	I45.8
ICD-9	426.82
DiseasesDB	11104
MeSH	D008133