Acquired long QT syndrome: a focus for the general pediatrician

Pediatr Emerg Care. 2014 Apr;30(4):257-61. doi: 10.1097/PEC.0000000000000108.

Abstract

Acquired long QT syndrome (LQTS) is a disorder of cardiac repolarization most often due to specific drugs, hypokalemia, or hypomagnesemia that may precipitate torsade de pointes and cause sudden cardiac death. Common presentations of the LQTS are palpitations, presyncope, syncope, cardiac arrest, and seizures. An abnormal 12-lead electrocardiogram obtained while the patient is at rest is the key to diagnosis. The occurrence of drug-induced LQTS is unpredictable in any given individual, but a common observation is that most patients have at least 1 identifiable risk factor in addition to drug exposure. The cornerstone of the management of acquired LQTS includes the identification and discontinuation of any precipitating drug and the correction of metabolic abnormalities, such as hypokalemia or hypomagnesemia. Most of the episodes of torsade de pointes are short-lived and terminate spontaneously. We propose a management protocol that could be useful for the daily practice in the emergency pediatric department to reduce the risk of acquired QT prolongation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Death, Sudden, Cardiac / etiology
  • Electrocardiography
  • Female
  • General Practitioners
  • Humans
  • Long QT Syndrome / diagnosis*
  • Long QT Syndrome / drug therapy
  • Long QT Syndrome / etiology
  • Ondansetron / adverse effects
  • Ondansetron / therapeutic use
  • Risk Factors
  • Serotonin Antagonists / adverse effects
  • Serotonin Antagonists / therapeutic use

Substances

  • Serotonin Antagonists
  • Ondansetron