Long QT syndrome (LQTS) is a heart condition. It consists of an alteration of the guts’s electrical system, which causes its rhythm to change into fast and chaotic.

The guts is the organ in control of pumping oxygenated blood to all parts of the body. Subsequently, when it doesn’t beat properly, the blood flow to other organs can be altered.

That’s why long QT syndrome can result in seizures, fainting, and even death.

The issue is that this condition can have multiple causes, starting from medical or metabolic to genetic. In this text, we’re going to elucidate every part it’s essential know concerning the syndrome and why it occurs.

What’s Long QT syndrome?

Long QT syndrome is a disorder of the guts’s electrical activity. As explained in an article by the Nemours Foundation, this disease makes it difficult for the guts to beat normally.

The structure of the guts isn’t affected. To be able to understand this syndrome, it’s essential to first understand how the guts works. With each beat, the organ pushes a sufficient amount of blood to the tissues. The beats are produced by a series of electrical changes that happen in the guts cells.

This electrical system allows the guts to beat rhythmically and at an appropriate rate in order that the chambers can fill well with blood. What happens in long QT syndrome is that, as a consequence of the electrical disturbance, the guts takes longer to get well between beats.

Because of this, the guts chambers fail to fill completely with blood. As well as, the rhythm is disturbed and the beats change into increasingly irregular.

Causes of long QT syndrome

Long QT syndrome can have multiple causes. Generally speaking, it’s divided into two important types: congenital and purchased. The previous, as its name suggests, is present from birth. In the next sections, we’ll explain every one specifically.

Congenital causes

Congenital long QT syndrome is as a consequence of a genetic alteration. Quite a few genes have been identified that could possibly be involved within the pathology, as summarized in an article in EMC-Pediatrics.

In a simplified way, a distinction is made between those causes transmitted by autosomal dominant inheritance and the others, of recessive inheritance. Cases of autosomal recessive inheritance are often more severe and are inclined to be related to deafness.

Acquired long QT syndrome

Acquired long QT syndrome is way more common than congenital. The important reason behind its occurrence is medication. There may be a multitude of medication that may lengthen the QT segment, amongst which we discover:

• Antipsychotics
• Antibiotics corresponding to azithromycin
• Antiarrhythmics

Then again, electrolyte imbalances are also a big cause. The syndrome often appears when the degrees of potassium, calcium, or magnesium within the blood drop.

In the course of the COVID-19 pandemic, the syndrome was associated with SARS-CoV-2 infection.

What symptoms does it produce?

As explained by Mayo Clinic specialists, long QT syndrome doesn’t at all times present symptoms. The truth is, many cases are detected by testing for another excuse or suspected by family history.

Nonetheless, there’s also a really high percentage of people that do have symptoms. Probably the most common symptom is fainting or syncope. It’s common for these people to faint during exercise or within the face of strong emotions. Sometimes there are pre-fainting signs corresponding to palpitations, lightheadedness, and weakness.

Other patients have seizures. In some cases, if electrical activity doesn’t return to normal, death may even occur.

The symptoms related to long QT syndrome can occur at any time of the day, even during sleep. Generally, this disease makes its debut after the age of 40 and may be very rare before that decade, as reported in Gene Reviews.

Complications of long QT syndrome

Some of the common complications is named torsade de pointes. It is a variety of ventricular arrhythmia that causes the ventricles to beat uncontrollably and rapidly. This leads to the guts being unable to pump blood normally. Because of this, the cerebral blood supply may fail.

Ventricular fibrillation is one other typical complication of this syndrome. It’s one of the vital dangerous arrhythmias; if not defibrillated, it results in death. As well as, fainting can result in falls or other serious accidents.

How is long QT syndrome diagnosed?

Diagnosis of long QT syndrome, as noted in a Texas Heart Institute article, requires numerous additional tests. The electrical activity of the guts have to be observed to verify the alteration.

For this purpose, essentially the most commonly used test is the electrocardiogram. This records the electrical activity of the guts. It might be used to find out whether the QT interval is lengthened.

The Q wave refers to ventricular depolarization and the T wave to repolarization.

In some cases, a Holter study is performed. It is a test that enables the guts rhythm to be monitored for twenty-four hours or more. This means that you can see if the syndrome occurs at any time in the course of the day.

How can it’s treated?

Long QT syndrome is often treated as soon because it’s detected. Otherwise, it increases the chance of sudden death. As well as, in lots of cases, lifestyle or lifestyle changes are enough to cut back the likelihood of a fatal event.

When the cause is a drug, it’s most frequently withdrawn or replaced with one other medication. If it’s an electrolyte disorder, it can be corrected promptly. As laid out in a 2022 report, the mix of certain drugs prescribed for vomiting plus the lack of electrolytes from the vomiting itself is a high-risk combination for the syndrome to occur.

Medications used to treat long QT syndrome

There are numerous drugs that could be used to guard patients with long QT syndrome. Probably the most commonly used are beta-blockers, corresponding to propranolol or nadolol. These drugs help to slow the guts rate and reduce episodes of QT prolongation.

In other patients, mexiletine is used. It’s often combined with a beta-blocker. It reduces the chance of seizures and fainting.

Surgery or other procedures

Along with medical treatment, long QT syndrome may profit from other interventions. One among these is surgery. As a study within the Revista Española de Cardiología explains, the surgery consists of sympathetic denervation of the left heart.

Subsequently, it is a technique that attempts to remove the innervation of the sympathetic nervous system from that a part of the guts. The sympathetic nervous system is one in every of the regulators of cardiac rhythm. This prevents the guts from racing too fast and reduces the chance of sudden death.

This treatment is often reserved for cases that don’t respond well to drugs. Another choice is to implant a defibrillator or pacemaker. These are devices that control the guts’s rhythm. They deliver small electrical shocks when the organ fails.

Long QT syndrome increases an individual’s risk of sudden death

Long QT syndrome is a disturbance in the guts’s electrical system. It causes the guts to beat in an uncontrolled, arrhythmic manner every now and then. Many individuals may remain asymptomatic for long periods of time.

If an individual has repeated unexplained fainting spells or seizures, it’s essential to seek the advice of a physician. Family history also needs to at all times be considered when searching for a diagnosis.

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