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What Are The Symptoms Of Long QT Syndrome?
Question: EKG showing prolonged QTc. Believed to be due to drug interaction (SSRI, Zoloft). I'm concerned because I had a prolonged QTc back in late 2009 and no one followed up on it. then now in 2014 I had two EKGs with it over 500--only explanation Cardiatric staff could give me was that it was prolonged. I'm concerned on whether or not I have undiagnosed Long QT syndrome. I have never fainted.
Brief Answer:
You may suffer from long QT syndrome...
Detailed Answer:
Hi XXXX
Although you never faint my oppinion is that you may suffer from Long QT syndrome. In some cases patient with long QT syndrome may be asymptomatic (and still suffering from this syndrome).
Apart family history or Prolonged QT syndrome (i.e hereditary long QT syndrome), other causes to prolonged QTc may be due to medications (anti depressive, macrolids antibiotics ect).
In your case I recommend to take a second opinion to confirm the diagnosis of long QT syndrome.
If you were my patient i would like to suggest avoiding:
- the use of Zoloft
- the use of antibiotcs of macrolides group (e.g. azythromycin)
- intense physical activity (which will prevent fainting and lifethreatening ventricula tachycardia)
Moreover if you were my patient i would recommend to run the following examinations:
- Repeat the stress test (medication)
- ECG monitoring (or ECG event monitoring)
- Genetic testing for long QT syndrome.
Hope it helped!
Dr.Benard
You may suffer from long QT syndrome...
Detailed Answer:
Hi XXXX
Although you never faint my oppinion is that you may suffer from Long QT syndrome. In some cases patient with long QT syndrome may be asymptomatic (and still suffering from this syndrome).
Apart family history or Prolonged QT syndrome (i.e hereditary long QT syndrome), other causes to prolonged QTc may be due to medications (anti depressive, macrolids antibiotics ect).
In your case I recommend to take a second opinion to confirm the diagnosis of long QT syndrome.
If you were my patient i would like to suggest avoiding:
- the use of Zoloft
- the use of antibiotcs of macrolides group (e.g. azythromycin)
- intense physical activity (which will prevent fainting and lifethreatening ventricula tachycardia)
Moreover if you were my patient i would recommend to run the following examinations:
- Repeat the stress test (medication)
- ECG monitoring (or ECG event monitoring)
- Genetic testing for long QT syndrome.
Hope it helped!
Dr.Benard
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hi dr Benard
I should also mention that all of my ekgs from 1988 until 2009 were normal QTc's. I was an elite running athlete throughout high school and two years of college. Wouldn't someone in my family have to have it? It wasn't until I develiped severe anxiety and started taking meds that my QTc started raising. Maybe I'm more sensitive to the changes, I'm not sure. Do you recommend I get a manual reading of my EKGs? Also, my last EKG after coming off of zoloft was normal. I understand long qt may not show up on ekgs, but due to all the running I did while younger, wouldn't it have showed up? Why don't the doctors seem to be concerned? I had a full work up through a cardiologist back in 2003--wouldn't they have caught my long qt if I had it then? I thought it would show up during the medically induced stress test (I had the injection). Thank you. Also, I can provide you with some ekgs and write ups from my heart ultrasound and other tests.
I should also mention that all of my ekgs from 1988 until 2009 were normal QTc's. I was an elite running athlete throughout high school and two years of college. Wouldn't someone in my family have to have it? It wasn't until I develiped severe anxiety and started taking meds that my QTc started raising. Maybe I'm more sensitive to the changes, I'm not sure. Do you recommend I get a manual reading of my EKGs? Also, my last EKG after coming off of zoloft was normal. I understand long qt may not show up on ekgs, but due to all the running I did while younger, wouldn't it have showed up? Why don't the doctors seem to be concerned? I had a full work up through a cardiologist back in 2003--wouldn't they have caught my long qt if I had it then? I thought it would show up during the medically induced stress test (I had the injection). Thank you. Also, I can provide you with some ekgs and write ups from my heart ultrasound and other tests.
Brief Answer:
Get manual reading of EKGs...
Detailed Answer:
Hi back,
1. Yes, I do recommend to get manual reading of your EKGs together with other tests as mentioned earlier (including genetic testing).
2. Although excessive training (you were an athlete) may uncovered the long QT syndrome, this isn't always true. In your case the use of specific drugs (zoloft in your case) uncovered the long QT syndrome.
3. Your prolonged QT syndrome is precipitated by use of Zoloft. In 2003 you were not using Zoloft, so, it was impossible to caught prolonged QT then.
4. If your doctors isn't concerned, than i recommend to look for a second opinion from a different doctor.
Hope it helped!
Dr.Benard
Get manual reading of EKGs...
Detailed Answer:
Hi back,
1. Yes, I do recommend to get manual reading of your EKGs together with other tests as mentioned earlier (including genetic testing).
2. Although excessive training (you were an athlete) may uncovered the long QT syndrome, this isn't always true. In your case the use of specific drugs (zoloft in your case) uncovered the long QT syndrome.
3. Your prolonged QT syndrome is precipitated by use of Zoloft. In 2003 you were not using Zoloft, so, it was impossible to caught prolonged QT then.
4. If your doctors isn't concerned, than i recommend to look for a second opinion from a different doctor.
Hope it helped!
Dr.Benard
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I agree and am ourauing a manual reading--what throws me kff is your comment that the zoloft uncovered a genetic long qt sybdrome versus the zoloft causibg a temporary drug induced prolonged qt. Thats the first time ive heard of that reasoning. What makes you think that this is not drug acquired long qt? Wasnt it a positive sign that once i got off of it my qt score went back to normal? Thank you.
Brief Answer:
Get the genetic testing done first...
Detailed Answer:
Hi back,
To get the answer to your questions, I advise to run the genetic testing. After we get the results, we can finally determine the prolonged QT syndrome.
I usually want to make sure the diagnosis made to my patients is correct. That's why I ask to run certain lab tests to ease the identification of final diagnosis.
The same happens in your case, without the results of genetic testing, no final conclusions can be make.
Let me know then!
Dr.Benard
Get the genetic testing done first...
Detailed Answer:
Hi back,
To get the answer to your questions, I advise to run the genetic testing. After we get the results, we can finally determine the prolonged QT syndrome.
I usually want to make sure the diagnosis made to my patients is correct. That's why I ask to run certain lab tests to ease the identification of final diagnosis.
The same happens in your case, without the results of genetic testing, no final conclusions can be make.
Let me know then!
Dr.Benard
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Found an ekg from my mom when she was in her 50's. Her qtc was 429. Dad has no ekgs with prolonged qtc either--he was a pilot and had to get ekgs every year. No history if fainting for either. Can severe anxiety and inverted t waves mess up a reading? Also, docs and cardiologists told me inverted t waves mean nothing--if inhave them can it theow the readibg off?
Brief Answer:
Can you upload your ECG...
Detailed Answer:
Hi again!
The long QT syndrome is divided:
- Inherited long Qt syndrome
- Acquired long Qt syndrome.
Although your parents have a normal ECG, this doesn't necessary exclude inherited long QT syndrome. If the genetic test are normal than you have acquired long QT syndrome .
I would like to reasure you that anxiety and inverted T wave doesn't mess up ECG readings.
However can you upload the ECG so i will check the ECG by my self? This way i will be able to find if inverted T has a clinical significance.
I'm waiting for the ECG to be uploaded.
Dr. Benard
Can you upload your ECG...
Detailed Answer:
Hi again!
The long QT syndrome is divided:
- Inherited long Qt syndrome
- Acquired long Qt syndrome.
Although your parents have a normal ECG, this doesn't necessary exclude inherited long QT syndrome. If the genetic test are normal than you have acquired long QT syndrome .
I would like to reasure you that anxiety and inverted T wave doesn't mess up ECG readings.
However can you upload the ECG so i will check the ECG by my self? This way i will be able to find if inverted T has a clinical significance.
I'm waiting for the ECG to be uploaded.
Dr. Benard
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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