Prolonged QT or something else?

[KaMa]

Hi-

My family has a history of Prolonged QT Syndrome, and I have a personal history of palpitations, dizziness, and chest discomfort (sometimes pain) since I was a teenager.  I am 32.

I have also been to a number of cardiologists over the years, who have given me stress tests, echos, halters, and recently I had a Myoview stress test.  All have been normal, though I was once told that my QT interval was slightly out of range but not yet considered long.  I'm currently on an event monitor, which has caught an example of ventricular fibrillation so far.  While I've recorded minor symptoms on the monitor, I have yet to catch one of the very big examples of palpitations that I have periodically, so my doctor has agreed to continue the event monitor until we see one.

My question is this:  have Prolonged QT problems ever been known in someone whose symptoms do not seem to occur with adrenaline?  Mine tend to occur during rest.  Would you say that the next step is Electrophysiology Testing, or is there some alternative you'd suggest?

Thank you,

Kathy

[CCF-M.D.-KE]

Dear KaMa,

You have congenital long QT syndrome and have been experiencing palpitations and a run of ventricular fibrillation on holter monitoring. Prolonged QT can be an inherited condition as it is in your case. Beta blockers have been shown to be helpful in this disorder, but their absolute effects may be dependent on the specific genetic abnormality causing QT prolongation. The inherited form of QT syndrome results in arrhythmias following a catecholamine (adrenergic) surge. In acquired long QT syndrome arrhythmias may be precipitated by pauses in the heart rhythm and less influenced by adrenergic responses. In congenital long QT syndrome beta blockers, and surgical sympathectomy are options. Also, placement of an internal defibrillator is another option.
This is a condition associated with sudden death, and I would recommend seeing an expert in this field very soon. You should make an appointment at a nearby university based medical center. Also visit our website at www.ccf.org or call at 1-800-CCF-CARE to schedule an appointment in the electrophysiology division of cardiology. Keep us posted on your condition.


Thanks for your question,



CCF-MD-KE

[KaMa]

Hankstar - thanks for the good point.  Well, the dr said it was 5 beats in the lower chamber.  She later called it ventricular something.  That may be an important point to know for a good answer!

crs7568 - Thank you SO much for posting.

[crs7568]

Hi Kathy.
Sorry to hear about your problems.  I, for one, can definitely say that pvc's frequently happen while at rest.  I was diagnosed with lqts after having so many palpitations during dinner one night that I had to go to the emergency room.  I now take Atenolol but still have many pvc's.  While they do happen from a sudden burst of adrenaline as in a case where you are suddenly frightened, in my particular case they are all too common even while watching television or trying to go to sleep at night.  Indeed, my mother experiences the same thing.  Your history certainly sounds like lqts but I am not a doctor.  I would keep wearing the monitor and get an appointment to see an Electrophysiologist.  Good luck to you.  I know how scary it can be.