Acquired long QT syndrome: a focus for the general pediatrician.
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.
From the *Department of Women and Children and General and Specialized Surgery, Seconda Università degli Studi di Napoli, Naples and †Institute for Maternal and Child Health-IRCCS, Burlo Garofolo, University of Trieste, Trieste, Italy.
Pierluigi
P
Marzuillo
Alessandra
A
Benettoni
Claudio
C
Germani
Giovanna
G
Ferrara
Biancamaria
B
D'Agata
Egidio
E
Barbi
D000293:Adolescent; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D058005:General Practitioners; D006801:Humans; D008133:Long QT Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D017294:Ondansetron / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors; D012702:Serotonin Antagonists / Q000009:adverse effects / Q000627:therapeutic use
D012702:Serotonin Antagonists; D017294:Ondansetron