Long t

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There are seven known types of inherited LQTS types 1 though 7. The most common types are LQTS 1, 2, and 3. This may cause problems when you exercise or when you have strong emotions. You may develop a rapid, uncontrollable heart rhythm that prevents your heart from pumping blood. This can trigger a rapid, uncontrollable heart rhythm that can be fatal. In LQTS 3, problems usually occur when your heart beats slower than normal, such as during sleep.

More than 50 medicines have been found to cause LQTS. Some common medicines that may cause the disorder include:. Some people who have medication-induced LQTS also may have an inherited form of the disorder. They may not have symptoms unless they take medicines that lengthen the QT interval or lower potassium levels in the blood. Severe diarrhea or vomiting that causes a major loss of potassium or sodium ions from the bloodstream may cause LQTS.

The disorder lasts until these ion levels return to normal. The eating disorders anorexia nervosa and bulimia and some thyroid disorders may cause a drop in potassium ion levels in the blood, causing LQTS. Experts think that about 1 in 7, people has LQTS.

But no one knows for sure, because LQTS often goes undiagnosed. LQTS causes about 3, to 4, sudden deaths in children and young adults each year in the United States. Unexplained sudden deaths in children are rare. When they do occur, LQTS often is the cause. Inherited LQTS usually is first detected during childhood or young adulthood.

The condition rarely is diagnosed after age If this happens, the risk of LQTS symptoms and complications goes down. LQTS is more common in women than men. Women who have LQTS are more likely to faint or die suddenly from the disorder during menstruation and shortly after giving birth.

Children who are born deaf also are at increased risk for LQTS. This is because the same genetic problem that affects hearing also affects the function of ion channels in the heart. Unexplained fainting or seizures, drowning or near drowning, and unexplained sudden death are all possible signs of LQTS. Your doctor can tell you whether your prescription or over-the-counter medicines might do this.

You also may develop LQTS if you have excessive vomiting or diarrhea or other conditions that cause low blood levels of potassium or sodium. These conditions include the eating disorders anorexia nervosa and bulimia, as well as some thyroid disorders. Signs and symptoms of LQTS-related arrhythmias often first occur during childhood and include:. Often, people who have LQTS 3 develop an abnormal heart rhythm during sleep.

This may cause noisy gasping while sleeping. This is called silent LQTS. For this reason, doctors often advise family members of people who have LQTS to be tested for the disorder, even if they have no symptoms. Medical and genetic tests may reveal whether these family members have LQTS and what type of the condition they have. Cardiologists are doctors who specialize in diagnosing and treating heart diseases and conditions.

To diagnose LQTS, your cardiologist will consider your:. Often, doctors first discover a long QT interval when an EKG is done for another suspected heart problem. The QT interval may change from time to time; it may be long sometimes and normal at other times. Thus, your doctor may want you to have several EKG tests over a period of days or weeks. Or, your doctor may have you wear a device called a Holter monitor. It can detect heart problems that occur for only a few minutes out of the day.

You wear small patches called electrodes on your chest. Wires connect the patches to a small, portable recorder. You can clip the recorder to a belt, keep it in a pocket, or hang it around your neck. While you wear the monitor, you do your usual daily activities. You also keep a notebook, noting any symptoms you have and the time they occur. You then return both the recorder and the notebook to your doctor to read the results. Your doctor can see how your heart was beating at the time you had symptoms.

Some people have a long QT interval only while they exercise. For this reason, your doctor may recommend that you have a stress test. During a stress test, you exercise to make your heart work hard and beat fast. An EKG is done while you exercise. Symptoms may include:. Your doctor may ask what over-the-counter, prescription, or other drugs you take. He or she also may want to know whether anyone in your family has been diagnosed with or has had signs of LQTS.

Signs of LQTS include unexplained fainting, drowning, sudden cardiac arrest , or sudden death. Your doctor will check you for signs of conditions that may lower blood levels of potassium or sodium. These conditions include the eating disorders anorexia nervosa and bulimia, excessive vomiting or diarrhea, and certain thyroid disorders. Genetic blood tests can detect some forms of inherited LQTS. If your doctor thinks that you have LQTS, he or she may suggest genetic testing.

Genetic blood tests usually are suggested for family members of people who have LQTS as well. So, even if you have the disorder, the tests may not show it. These people may have silent LQTS. Less than 10 percent of these people will faint or suddenly die from an abnormal heart rhythm. Even if you have silent LQTS, you may be at increased risk of having an abnormal heart rhythm while taking medicines that affect potassium ion channels or blood levels of potassium.

If you have inherited LQTS, it may be helpful to know which type you have. This will help you and your doctor plan your treatment and decide which lifestyle changes you should make. The goal of treating long QT syndrome LQTS is to prevent life-threatening, abnormal heart rhythms and fainting spells. However, treatment greatly improves the chances of survival. The type of medicine you take will depend on the type of LQTS you have.

For example, doctors usually will prescribe sodium channel blocker medicines only for people who have LQTS 3. These treatments may include:. People at increased risk are those who have fainted or who have had dangerous heart rhythms from their LQTS.

If possible, try to avoid things that can trigger abnormal heart rhythms. For example, people who have LQTS should avoid medicines that lengthen the QT interval or lower potassium blood levels. Many people who have LQTS also benefit from adding more potassium to their diets. Check with your doctor about eating more potassium-rich foods such as bananas or taking potassium supplements daily.

Beta blockers are medicines that prevent the heart from beating faster in response to physical or emotional stress. Most people who have LQTS are treated with beta blockers. Doctors may suggest that people who have LQTS 3 take sodium channel blockers, such as mexiletine. These medicines make sodium ion channels less active. Pacemakers and ICDs are small devices that help control abnormal heart rhythms.

Both devices use electrical currents to prompt the heart to beat normally. Surgeons implant pacemakers and ICDs in the chest or belly with a minor procedure. The use of these devices is similar in children and adults. However, because children are still growing, other issues may arise.

For example, as children grow, they may need to have their devices replaced. People who are at high risk of death from LQTS sometimes are treated with surgery. During surgery, the nerves that prompt the heart to beat faster in response to physical or emotional stress are cut. This type of surgery keeps the heart beating at a steady pace and lowers the risk of dangerous heart rhythms in response to stress or exercise.

The risk of having an abnormal heart rhythm that leads to fainting or sudden cardiac arrest may lessen as you age. However, the risk never completely goes away. You can:. If exercise triggers an abnormal heart rhythm, your doctor may tell you to avoid any strenuous exercise, especially swimming.

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