Does temporary acquired LQTS exist?

March 21, 2007 8:31 AM

Has anyone else had acquired LQTS that is only temporary (and sometimes comes and goes)? Because I'm starting to wonder if that is the case with me.

Yes, I know, the first thing people will say is SEE A DOCTOR. If I said how many doctors I saw last year, you'd understand why I don't want to bother asking them again since I can't seem to get a straight freakin' answer!

This was how it started - I ended up passed out on my kitchen floor last July, and was taken to the emergency room because I just couldn't seem to come out of it. Note - if you pass out, and don't know why, don't try to even SIT up, 'cause you'll just pass out again most likely. Anyway, everything seemed great, they said it was just vasovagal syncope (doctor talk for "fainting") because I'd not eaten all day. I was told I'd go home that night, everything would be swell.

All of a sudden, one of the ER docs RUSHED into the room, saying they were keeping me overnight, talking about me having a prolonged QT, "sudden death" (not talking hockey here), congenital crapola, and basically scared the crap out of my mother (thankfully, I was still too out of it to be scared, I was just pissed off that he did that to my mom).

After going through utter HELL trying to get out of the hospital the next day, they told me that it had just the prolonged QT had just been temporary due to a severe drop in my electrolytes (potassium in particular, but also magnesium). And that was why I fainted.

What I want to know is, has anyone else had similar problems? I have had moments of near-fainting several times, but frankly am tired of doctors. You have no idea. I also have been getting palpitations again lately, like I did then. If this is just a matter of me eating more bananas, then I'll do that again (even though I'm sick to death of them now).

Btw, prolong QT syndrome (LQTS) is an electrical disturbance in the heart, that is attributed to SADS as well as being looked into seriously as a cause of SIDS. There is congenital and acquired LQTS, the latter usually caused by taking certain medications (I have a whole shopping list of meds that I take for epilepsy, asthma, etc.). Oh yeah, it's often misdiagnosed as epilepsy, but I doubt that is the case with me.

Like I said, I know most people's first thought will be to see a doctor. My question is has anyone else experienced this. I've been to the doctors, and since I've been a medical eniqma my entire life, I don't always completely trust tests.

Oh, and btw, I'm 30 years old, weigh about 150 (about half what I was two years ago), and am 5'7".

posted by ForeverAKid to health & fitness (7 comments total)

Not a suggestion that you go and see another doctor, just a question for more information -- did they have you do a 24 hour Holter monitor after your electrolytes were re-balanced? If so, did that show any QT problems?
posted by katemonster at 8:38 AM on March 21, 2007

Also, according to QTsyndrome.ch, "A QTc at or above 480 milliseconds in females or 470 milliseconds in males, is probably a sign for long-QT syndrome, in the absence of drugs, electrolyte disturbance, or other conditions that might independently lengthen the QT-interval." (emphasis mine).
So that would say to me that electrolyte imbalance alone can cause what you experienced, and that it's not necessarily indicative of underlying LQTS.
posted by katemonster at 8:42 AM on March 21, 2007

There are too many things that could be causing what you describe to identify it from your description. You'll probably get a lot of hands raised - "Hey! I had that!" - but the chances are that the similarities were just superficial.

Honestly, when I see patients wandering around asking other patients for help diagnosing their long QT syndrome, or something else they're not qualified to understand, my red flag goes up. This isn't how you get well; this is, however, how you drive yourself nuts, find false confidence, and talk yourself out of getting the health care you need.

You need not just a doctor, but a very good doctor. Have you considered taking a trip to see an academic cardiologist at your local university medical center?
posted by ikkyu2 at 11:23 AM on March 21, 2007

I know you don't want to be told to go to a doctor, but LQT is nothing to dick around with. The fact that you're "getting palpitations again," although it could be a case of hypochondria, is very alarming. Nthing the suggesting to see a good doctor, who can not only monitor your ECG over a longer period of time now that your electrolytes are more balanced, but also figure out why they were so severly out of whack in the first place. That sort of hypokalemia, severe enough to disrupt the electrical conduction of the heart, is something you need to make sure doesn't happen again. Normal healthy people don't have to work so hard to keep their electrolytes in balance.

To sum up: acquired LQTS happens, and you're lucky that your incident was relatively benign. Repeated or ongoing acquired LQTS, however, is incredibly serious, as you seem to know from your post in which you acknowledge the link between LQT and sudden cardiac death. Find a good doctor. If you happen to be in the NYC area, I know a few who do research on congenital factors of the syndrome and who treat it clinically.
posted by twoporedomain at 3:05 PM on March 21, 2007

Seconding ikkyu2's suggestion to find a top notch cardiologist. You might also consider getting tested for Lyme disease which can present with cardiac symptoms.
posted by zoel at 5:50 PM on March 21, 2007

I go to other patients because I can never seem to get straight answers from doctors. Trust me, trying to find out why I was getting a shot in the stomach the next day was hard enough. Which I finally found out was just Heparin, but still.

I have seen a cardiologist. In fact, the week before I passed out, I had an echo and then a treadmill stress test. The day before I passed out, I was told everything was perfectly normal. Then I end up being admitted for something possibly being wrong with my heart?

I was supposed to see an electro-physiologist when I was in the hospital and have the tilt test, but they decided (the doctors) that it wasn't necessary.

I did not wear a Holter monitor, but I was in the hospital hooked up to an EKG machine for 24 hours after my potassium levels were normal. The EKG was normal when the electrolytes were normal.

Not in the NYC area, but in the Chicago area, so yes, we have plenty (seriously) of big hospitals around here.

Mind you, my question was merely is this something that can happen on and off. That part I'm just not sure about. I'd never even heard of it until that day in the hospital. And I was rather out of it considering I'd passed out.

And if I sound grumpy about this subject, I apologize.
posted by ForeverAKid at 11:38 AM on March 22, 2007

It sounds like you may well have had acquired LQTS if this was in association with severe electrolyte disturbances, and resolved on telemetry when they corrected it. If this is the case, as much as you hate doctors, please stop dicking around. If you lost consciousness because you went into polymorphic ventricular tachycardia as a result of LQTS, you need to get this all figured out and fixed as soon as possible -- ie before it happens again and you die.

It really is fairly unusual for an otherwise healthy 30-year-old to develop that degree of hypokalemia and hypomagnesemia, as someone else already noted. If noone has addressed that issue, figured out if it was an isolated incident or a recurring problem, what the cause was, etc. then you really should seek out a good internist. While seeing a good cardiologist or electrophysiologist probably wouldn't hurt, it sounds more like the electrolytes are the heart of the problem here (no pun intended).
posted by drpynchon at 9:41 PM on March 23, 2007