Pediatric Heart Expert Forum
Borderline Prolonged QT
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Borderline Prolonged QT

My 13 years dtr has been on Lexparo and Focalin XR.  She recently had an ECG and the term "Borderline Prolonged QT" was used.  Our family physician cleared her to remain on the medications but the physician treating her for Depression and ADHD will not clear her for the Focalin XR.  We are scheduled to see a Pediatric Cardiologist next week.  Any advice?
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773637_tn?1327450515
Dear PJ,

Without seeing the ECG, I cannot say for sure what the issues are.  That said, the corrected QT (QTc) interval is the most difficult measurement that the ECG computer performs, and it is not always correct.  Therefore, the most important advice I can give you is to make sure that the pediatric cardiologist hand-measures the QTc interval if there is a specific question about its duration.  As well, the appearance of the T waves and certain other findings on the ECG can be helpful in confirming or denying the diagnosis.  Finally, a personal and/or family history of long QT, seizures, syncope (passing out, especially face-planting in the case of long QT), sudden cardiac death under the age of 50, bizarre deaths under age 35 (good swimmer who drowned, good driver who fell asleep and hit a tree, etc.), and hearing loss are all important historical features that may support the diagnosis.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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Marie M Gleason, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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