Long QT

[annlouhal]

A number of years ago I developed palpitations. I also, on occasion would hear a clicking noise in my head and I would have a dizzy spell -sometimes the room seemed to spin around me whilst I was sitting still - these symptoms did not necessarily appear together. I have never had high blood pressure apart from one time when I went in to hospital to have work done to my teeth and blood pressure was borderline so they sent me home.  I have had numerous ECG's, wore a Holter on several occasions to cover a period of 24 hours, had a small? heart scan and a stress test on running machine. On one occasion it was noted on ECG at GP surgery that I had a Long QT. I have never appeared to suffer from high blood pressure. But I do suffer from anxiety which has come and gone over the past few years. Recently I moved home and was taken on by a new doctor. A lot of negative things had happened in my life and my new doctor (she is very nice) wished me to be put on to Sertraline (along with a therapist for self-help) to try to manage low mood and anxiety. She wished to check to see if an ECG showed Long QT and so I underwent this at the surgery. I cannot remember if she told me that I was borderline or that it was ok...i think she meant the previous Long QT was borderline. My previous doctor had put me on Propanolol. I was also previously investigated by a Gastroentologist who advised that it was his belief that I suffered from acid reflux and that this was causing my palpitations. These palpitations (flutterings) only last for a second or two but I am constantly fearful now and am sure my anxiety is due to them now - catch 22. I am afraid to take the Sertraline as it has been known to cause a Long QT and as I am adopted there is no way of finding out if my natural parents or siblings suffered from this. My previous doctor advised me that he thought I suffered from Cardiophobia for I seem to be abnormally anxious regarding my heart and he was not familiar at the time just as to what a Long QT was. Unfortunately I googled it and scared myself stupid. I am currently taking Propanolol SR (palpitations and anxiety), Omeprazole (acid reflux), Oxytetracycline (acne roseacea), Gabapentin (for seriously bad restless legs), Amitriptyline (when needed for very bad back). I was previously on Temazepam for restless legs which I felt i had been on for too long and these were stopped. There have often been episodes where I have suddenly felt like a battery being suddenly depleted of all energy and this is usually after I have eaten. I am a vegetarian and eat no flesh whatsoever at all. Has anyone any ideas because I am really worried about this which makes me feel more jittery, anxious and low-mooded. The cardiologist told me that there was nothing wrong with my heart but I still worry. My doctors over the years have put my problems down to anxiousness and it is true that I am easily stressed as I am sure you can tell from this post. Can anyone help please. I will be 49 in a couple of months time. Only once in my life have i fainted and this was when i was a child dancing at a friends party. I just remember that I woke up on a bed and that my neck was too weak to enable me to lift my head. My mother, to this day, does not know what caused it and I dont think the doctor was contacted. I done gymnastics, sprinting and ice skating whilst at school and never fainted or had any problems but I never liked riding a bicycle because I always felt awful afterwards with a bright red face (maybe I really am a hypochondriac). When I have a heart flutter I can put my finger to my pulse and feel its chaotic beat. Scary.

[annlouhal]

Hi
Thanks for your post. What you say makes complete sense. I will go back to my doctor and ask to be referred once again to the cardiologist to rule out QT problem. I still havent taken my Sertaline for anxiety and low mood which I really should but am very worried about it for in rare cases it can cause heart attacks. I think I am just so obsessed that I am going crazy. I shall take your advice and follow it and try and be rational about it all. Once again thanks and kind regards to you.

[is_something_wrong]

Your QT time will change all the time, it depends on a lot of things; heart rate, what you eat, activity, stress, medications, etc. One EKG showing borderline prolonged QT is NOT diagnostic of long QT. Also, a cardiologist must interpret your EKG, as the machines often are wrong, and prolonged QT will also usually manifest with specific changes in the T wave too.

There are two variants of long QT. One is inherited and a genetic malfunction, the other is aquired and caused by electrolyte imbalances, metabolic disturbances, heart conditions causing a prolonged QT (cardiomyopathy or other causes) or medications.

If your cardiologist ruled out long QT, and your Holter and stress test didn't indicate a prolonged QT (they are better tests than a 6 second EKG), I would try to trust that. A normal stress test pretty much rules out LQTS as a genetic disorder, at least.

Even though the "borderline" limit in females are 450 msec (and be aware that the "QTc" equation often overestimates QT at high heart rates), the QT must be a lot longer to be dangerous. I would recommend going to a cardiologist with one specific question; "can you rule out LQTS?" It would probably not be very difficult.

[rilesnic]

Whole should've been hole...my apologies :)

[annlouhal]

Thanks rilesnic for your reply to my post. Whilst I was sitting reading what other people were feeling (so very similar to myself) I started to feel absolutely awful - so perhaps a part of it is brought on by my own fear - and took to my bed as I suddenly felt overwhelmingly weary. I am very tempted to try the Sertraline regardless of thoughts of Long QT as the adrenalin surges and jitteriness is awful. Thanks once again.

[rilesnic]

I'm sorry you're not feeling well. Since I was 22 (I'm now 39), I have had tachycardia, PVC's, and PAC's. I've had every heart test, and many of them. I take atenolol to help with the tachy, but a lot of it has been deemed anxiety and panic (which I do get when I feel my heart). I too was adopted, closed adoption. When my mother passed away 10 years ago and my children continued to have to be tested for diabetes, I decided to search. After 6 very long years, and A LOT of money paid to my adoption home (who actually put me on the wrong track), I found my birth families. My birthfather had died at the age of 35 from complications of juvenile diabetes. He had a stroke and was blind the last 2 years of his life. My birthmother suffered from anxiety, but no other health problems and everyone else was said to be healthy. My siblings were not contacted at my birthmother's request and I was not to contact her anymore. This lead me to more questions, and when I did finally contact her other children, my maternal grandmother passed away about a month later. She was 84. (My paternal grandparents are still living...both in their 80's). My maternal grandmother died from complications from heart surgery, and had complained of her heart "fluttering" her whole life. During surgery they found a whole in her heart that was never detected. So, I do believe my heart issues are genetic and my husband and I laugh because I'm also a "nut" by nature. My doctor has also told me that although I do suffer from anxiety, there are other issues triggering the heart, we just can't seem to pinpoint it. Make sure that you stay on top of your heart health. Being adopted does make it a little more difficult for you. Don't let anyone say it is all anxiety. I was told my heart is structurally normal too. No matter what anyone says, we know that a palpitation is an awareness of one's own heart, but it is not "normal" to feel of your heart. I am an anxious person, but I am anxious due to feeling every heart beat...regular and not. Always let your doctor know your concerns of a medication and your history of possible Long QT. There is nothing wrong with getting a second opinion, especially since you are feeling some dizziness. Keep us posted. I wish you the best!