title: A high-risk patient with long-QT syndrome with no response to cardioselective beta-blockers.
abstract: We present a case of a high-risk 19-year-old female with long-QT syndrome (LQTS) with compound mutations. She had a history of aborted cardiac arrest and syncope and had received treatment with propranolol for 15 years. However, because she developed adult-onset asthma we tried to switch propranolol, a nonselective beta-blocker, to beta-1-cardioselective agents, bisoprolol and metoprolol. These resulted in both a markedly prolonged corrected QT interval and the development of LQTS-associated arrhythmias. Eventually, propranolol was reinitiated at a higher dose with the addition of verapamil, and she has had no further cardiac or asthmatic events for 5 years.
authors.affiliation: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan. n-toyota@otsu.jrc.or.jp.|Department of Pediatrics, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu, 520-8511, Japan. n-toyota@otsu.jrc.or.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Toyota
authors.affiliation: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Miyazaki
authors.affiliation: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Heima
authors.initials: H
authors.lastname: Sakaguchi
authors.affiliation: Department of Cardiovascular Medicine, Division of Arrhythmias and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
authors.affiliation: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Ohuchi
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D004361:Drug Tolerance; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: Beta-1 selective blocker; Beta-blocker; High-risk patient; Long-QT syndrome; Nonselective beta-blocker