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Long Qt Wave
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Long Qt Wave

I am concerned about a prolonged QT wave.

Recently, I have obtained copies of some medical testing for a cardiovascular second opinion.

While reading these reports, I noticed that I have had multiple EKGs which show a prolonged QT wave.  
This information was never mentioned to me.

One EKG was for a presurgery workup.  After the cardiology workup, the orthopedic surgeon refused to repair my rotator cuff.  He said it was too dangerous.

A year later, I went to the hospital with horrific chest pains.  I had an abnormal EKG with st - T wave changes, non specific,  intraventricular condution delay and left atrial abnormality.  Later, the EKG was repeated with a diagnosis of a prolonged QT inverval QTC = 504 and was released.

I was told everything looked great.

I picked up the blood work that was done at the same time.  My blood levels were all in the normal range.  I also checked with my pharmist.  I was not taking any medication that would prolong a QT wave.

I would like to know how dangerous this is?

My daughter and I have both had adverse events with Avelox.  My daughter thought she was having a heart attack or a severe anxiety attack.  

This makes me think that this is hereditary.

Also, I would like to know if there is a relationship between asymmetric left ventricular hypertrophy and the prolonged QT?  

My understanding is that asymmetric left ventricular hypertrophy and long QT are inherited.  Is that correct?

Shouldn't this issues have been discussed with me based on my family history?

(I have a strong family history of heart attacks, fainting and sudden death.  My grandfather died suddenly in his early 40s of an MI.  My brother had a MI at age 32 which damaged 25% of his heart. I have other siblings with CABGs, MIs and HF. There are also many other sudden deaths in my family, aunts, uncles, cousins.  There have also been many near deaths where resuscitation was successful.)

Again, thank you for your insight.

Related Discussions
230125_tn?1193369457
There are many things that go into reading QT and corrected QT (QTc) on an EKG.  The important thing to remember is that the EKG measurements are often not correct.  The other important point is that it sounds like your family history is mostly coronary artery disease and not just sudden death.  I think it is very important that you gather your medical records and see a cardiologist or cardiac electrophysiologist.  If you live near an academic center, there may be someone there that specializes in genetic heart disease or genetic syndromes.

Hypertrophic cardiomyopathy (asymetric ventricular hypertrophy) can be inherited as can long QT  syndrome.  QRS duration and sometimes QT interval can be prolonged with ventricular hypertrophy.  Determining whether this represents Long QT syndrome or hypertrophic cardiomyopathy can be very tricky sometimes but other times is very straight forward.

I hope this answers your question and that your evaluation is shows that you are fine.
5 Comments
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Avatar_n_tn
Please go to another doctor!!!! With a QTc of 504 you are not fine!! I have Long QT Synrome with a similar family history and I had to go to several doctors before I found the right one. You need to see a heart rhythm specialist (Electrophysiologist). The US has some of the best in the world. Go to www.****.org or www.****.org and get in touch with someone there quickly to find a referal in your area of the US (presuming you are there). You can email or even call people there.
The ECG machine could have been wrong but since a surgeon wouldn't operate because of this I am thinking it was correct. In any case, see an Electrophysiologist as soon as you can. Keep yourself well hydrated, eat bananas, potatoes, raisins, watermelon to keep your potassium up and avoid ALL drugs on the long qt drug list at www.qtdrugs.org.
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Avatar_n_tn
Those are the SADS website and CARE website.
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Avatar_n_tn
Thanks so much for your post.

I consulted with a different cardiologist.  

She is concerned about the arrhythmias, PVCs, orthostatic hypertension and such but mostly the arrhythmias.

I pointed it out the long QT on the EKGs.  

She ordered some "stat" blood work and the next day, she scheduled me for a consulation with an electrophysiologist.
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Avatar_n_tn
I am so glad for you. And just to let you know, some people with LQTS do have blood pressure issues as well. Just because you have one problem doesn't mean that you can't have more. All have to be assessed. Electrophysiologists are great at looking at the electrical parts (LQTS) of the heart and they are cardiologists as well who know about the cardiovascular diseases so you will be in good hands. Rest assured.
Keep me posted!
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