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Dr. Andrew Rynne

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Suggest Treatment For Long QT Syndrome

Male 27yrs old, hx of prolonged QT syndrome, 6ft, 4in, 399 lbs, spina bifida occulta, fracture of vertibra near defect with 6mm hernination and torn roto cuff of left shoulder, seizures as a child status epiliticus, seizure free since 10 yrs old. for last 7 mths has episodes of sudden tachycardia (up to 270bpm) at rest. All S/S of acute MI, yet all test neg. Monitor, echo, and stress test all neg. After the episode subside, then severe headaches and total fatigue, sleeping up to 12 hrs or more after. Pt states he thinks that he is slowly dying and no one can find out why. I am his mother, so what else should I look at. Neuro next or what? Help please some suggestions, I am an retire RN and at a lose at what else to look at.
Tue, 3 Jan 2017
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Cardiologist 's  Response
Hello and welcome to ‘Ask A Doctor’ service.

I have reviewed your query and here is my advice.

You mentioned about the long QT syndrome. This 270 heart rate may be ventricular tachycardia then. At high heart rate one may chest pain and other symptoms of MI but it's no MI and it's entirely due to high rate which settle after heart rate is settled.

Test may be normal at this time except prolonged QT and will monitor will detect if episode recurs during monitoring. I think if it's prolonged qt then he must be started in Beta blockers which is guess must have been started. If he gets symptoms in beta blockers as well then he becomes a candidate for ICD.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Sagar Makode
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Suggest Treatment For Long QT Syndrome

Hello and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. You mentioned about the long QT syndrome. This 270 heart rate may be ventricular tachycardia then. At high heart rate one may chest pain and other symptoms of MI but it s no MI and it s entirely due to high rate which settle after heart rate is settled. Test may be normal at this time except prolonged QT and will monitor will detect if episode recurs during monitoring. I think if it s prolonged qt then he must be started in Beta blockers which is guess must have been started. If he gets symptoms in beta blockers as well then he becomes a candidate for ICD. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sagar Makode