Long QT

[Roxanne40]

Could you tell me if the cardiologist could pick up long QT syndrome on an ekg, or is there another test the doctor would have to perform.  My cardiologist has told me that I don't have long QT, but I've been told by another cardiologist (I used to be an EKG tech at another hospital) that according to the ekg that I showed him, it looked as if my QT was a little long and to stay away from medication that would make my heart race.  Does this sound normal to you. I have my cardiologist that I've had for 20 years tell me that I don't have long QT and then a physician that I showed an ekg that one of the techs performed on me, said it looked long.  Do you have any thought on this?  I am 40 and have had pvc's for 20 years.  My daughter passed out on the playground 2 years ago and we took her to the hospital and they performed an ekg and that was normal.  They just said she was dehydrated...She most recently passed out while having blood drawn, so I was just concerned.. Why do people pass out from having blood drawn?  

Thank you,

Roxanne

[CCF-M.D.-RCJ]

Roxanne,

Thanks for the post.

The EKG is the "gold-standard" for diagnosing long-QT syndrome.  A person's EKG changes from day to day depending on the circumstances -- more or less dietary potassium, dehydration, recent physical activity, anxiety, etc.  So it is not at all unusual for a slightly longer QT to appear on one EKG than another.

I tend to not put much stake in passer-by diagnoses.  If a physician simply looks at an EKG and knows nothing else about you, then you would be ill-advised to accept a diagnosis from that person.  Especially given that you have been followed by another cardiologist for 20 years!

The most common reason for people to "pass out" is from vaso-vagal syncope.  Common precipitants include anxiety, blood draws, emotional stress, among others.  Vasovagal syncope occurs either from an increase in parasympathetic activity or a decrease in sympathetic activity caused by one of the precipitators I listed above.  Many young persons experience this phenomenon, and it tends to go away with aging.

Hope that helps.

[Dr. Erik]

Long QT intervals do not always show up on an EKG. Some they do , some they don't. It is possible that it is present only some of the time. It would be interesting to see what your QT interval is during and after a stress test. That would give you a better idea. As for your daughter, Her fainting spell could definitely have been from the long QT. I'm not sure about the blood drawing incident. It could be long QT or just a Vaso-Vagal response to the incident. Either way, get both you and your daughter checked ASAP! There are internal defibrillators that can be implanted in you and your daughter that could end any possible threat of sudden death from a lethal arrythmia. I don't mean to scare you, it's just better to be safe than sorry. You may both be fine. It's just better to know. I wish you the best.

Erik

[Roxanne40]

Thank you so much for your quick response.  My daughter goes in tomorrow for a chicken pox vaccine and is so anxious that she will pass out again. She originally passed out from the draw of the chicken pox titre...Her father is going with us this time and I assume I will let her lay down a while before letting her get up and I will be sure to tell them what happened during the lab draw....

Thanks again for your input.  It is appreciated and respected...

Roxanne