Hi all, I am new here and am having some trouble dealing with my heart issues... I am looking for some answers and some moral support. I am a 27 year old female in good health (no HBP, no high cholesterol) and I have been having heart palpitations since I was 15. I went to the hospital in June due to a palpitation-related anxiety attack and was put on an EKG to monitor any palpitations. None came up during that time; however, I was looking back over the results today and saw that the EKG showed a QTc invertval of 498 when my heart rate was 86 BPM. The cardiologist didn't mention anything about it. I then went on a Holter monitor for 24 hours to check out the palpitations. It found ~850 PVCs, ~10 PACs, and one couplet. However, the Holter report did not mention the QTc interval. I will be asking my doctor for further results, but is it possible that the panic attack caused the high QTc interval? I have been reading about Long QT Syndrome and am terrified of it. I have never had a fainting episode, but am still scared. I plan on making an appointment with another cardiologist tomorrow for a second opinion.
Any thoughts or support would be highly appreciated!! Thank you!
The QT interval changes all the time, depending on several factors, but 498 seems a bit high and I think you're right seeing another cardiologist, especially if you have some PVCs.
You don't necessarily have LQTS even if your QT is prolonged. I think I read somewhere that 2,5% of all healthy people have prolonged QT but only 1:4000 actually have LQTS. I honestly think your cardiologist would have told you if he suspected LQTS. The Holter monitor measures QT interval (min, average, max) and is a better measurement for QT time than a short resting EKG.
In addition, LQTS is usually shown on EKG as changes in the T wave (enlarged, notched, etc). The diagnosis is confirmed by genetic testing.
I think it's a good idea to see another cardiologist for this specific diagnosis, and you should bring a copy of your first EKG and possibly the Holter report, just for him to compare with his tests. But if you haven't experienced fainting with palpitations, chances of LQTS aren't very high.
I understand that all genetic heart diseases are a bit scary. But even if you have LQTS, treatment is available (usually beta blockers and/or ICD).
Try to relax until you see another cardiologist :)
This is one of the reasons I think docs are leery of giving raw test results to patients. The raw results have to be analyzed in conjunction with other test results; more than one criteria has to be met to arrive at a conclusion (diagnosis).
Thank you both for your comments. I feel a bit better now. I called the cardiologist's office that performed the analysis of my Holter results and they said that if I had had abnormal QTc results that they would have been documented. They will be sending me the actual Holter strips so I can see for myself.
I have made an appointment with another cardiologist for the end of this month, so we will see what happens.
You need to see an experienced Electrophysiologist (EP), not just a cardiologist. Cardiologists are famous for down playing a prolonged QT. Holter monitoring is not the best way to diagnose Long QT Syndrome and some doctors don't even use them for this purpose.
If you showed a prolonged QT on an ECG it needs to be hand measured by an EP. Check with www.sads.org to find an experienced doctor in your area. You can even get a copy of your ECG and send a scanned copy to a specialist to be read. If you like, just private message me, and I can give you a couple of LQTS spcialists email addresses who would be happy to look at it for you. Sometimes the ecg machine can be wrong with the QT interval, especially when the heart rate is close to 90+. It could be just an error so having it read could save you a lot of worries. T wave shape also comes into play and only a specialist will be able to determine this. A cardioligist will most likely not have the experience with LQTS to recognize this.
Genetic Long QT Syndrome can be tricky to diagnose and LQTS can sometimes be acquired and temporary from taking certain medications or having another medical problem like Hypothyroidism, electrolyte imbalance, etc. Check out the QT Drug List website www.qtdrugs.org.
Bottom line is, a prolonged QT is a prolonged QT, whatever the cause, and this can lead to dangerous arrythmias and needs to checked out.
Please feel free to contact me with any other questions.
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