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1.
Int J Cardiol ; 316: 280-284, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32439366

RESUMO

BACKGROUND: Hydroxychloroquine and azithromycin combination therapy is often prescribed for coronavirus disease 2019 (COVID-19). Electrocardiographic (ECG) monitoring is warranted because both medications cause corrected QT-interval (QTc) prolongation. Whether QTc duration significantly varies during the day, potentially requiring multiple ECGs, remains to be established. METHODS: We performed 12­lead ECGs and 12­lead 24-h Holter ECG monitoring in all patients aged <80 years admitted to our medical unit for COVID-19, in oral therapy with hydroxychloroquine (200 mg, twice daily) and azithromycin (500 mg, once daily) for at least 3 days. A group of healthy individuals matched for age and sex served as control. RESULTS: Out of 126 patients, 22 (median age 64, 82% men) met the inclusion criteria. ECG after therapy showed longer QTc-interval than before therapy (450 vs 426 ms, p = .02). Four patients had a QTc ≥ 480 ms: they showed higher values of aspartate aminotransferase (52 vs 30 U/L, p = .03) and alanine aminotransferase (108 vs 33 U/L, p < .01) compared with those with QTc < 480 ms. At 24-h Holter ECG monitoring, 1 COVID-19 patient and no control had ≥1 run of non-sustained ventricular tachycardia (p = .4). No patients showed "R on T" premature ventricular beats. Analysis of 24-h QTc dynamics revealed that COVID-19 patients had higher QTc values than controls, with no significant hourly variability. CONCLUSION: Therapy with hydroxychloroquine and azithromycin prolongs QTc interval in patients with COVID-19, particularly in those with high levels of transaminases. Because QTc duration remains stable during the 24 h, multiple daily ECG are not recommendable.


Assuntos
Azitromicina , Infecções por Coronavirus/tratamento farmacológico , Eletrocardiografia/métodos , Hidroxicloroquina , Síndrome do QT Longo , Pandemias , Pneumonia Viral/tratamento farmacológico , Antivirais/administração & dosagem , Antivirais/efeitos adversos , Azitromicina/administração & dosagem , Azitromicina/efeitos adversos , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Morte Súbita Cardíaca/etiologia , Morte Súbita Cardíaca/prevenção & controle , Monitoramento de Medicamentos/métodos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Hidroxicloroquina/administração & dosagem , Hidroxicloroquina/efeitos adversos , Síndrome do QT Longo/induzido quimicamente , Síndrome do QT Longo/complicações , Síndrome do QT Longo/diagnóstico , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia
2.
Circ J ; 84(4): 559-568, 2020 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-32161207

RESUMO

BACKGROUND: Long QT syndrome type 8 (LQT8) is a rare genotype of long QT syndrome. Late-appearing T-waves (LaT) are often documented in patients with LQT8, as in long QT syndrome type 3 (LQT3); however, the frequency of LaT and its relevance to the clinical severity of LQT8 remains unclear. This study investigated T-wave morphology (TWM) in LQT3 and LQT8 patients and compared the phenotypes of different TWMs.Methods and Results:TWMs were classified into 3 types: early onset T-waves (EoT), LaT, and bifid T-waves (biT). Electrocardiogram (ECG) measurements, symptoms, and topology were compared among TWM types. The study cohort comprised 25 patients with LQT8 (14 mutations) and 25 patients with LQT3 (14 mutations). LaT was detected in 17 (68%) and 13 (52%) LQT8 and LQT3 patients, respectively. There were no significant differences in ECG measurements or the severity of symptoms between patients with LaT and those with other TWMs in either the LQT8 or LQT3 group. However, only patients with LaT experienced cardiopulmonary arrest. Compared with the LQT3 group, in the LQT8 group there was a tendency for mutations in patients with LaT to be located in domain-linking regions. CONCLUSIONS: In this study, two-thirds of patients with LQT8 exhibited LaT on ECG, and nearly one-third of those experienced cardiopulmonary arrest. Further investigations are warranted to differentiate between LQT3 and LQT8 in patients exhibiting LaT to optimize therapy.


Assuntos
Potenciais de Ação , Transtorno Autístico/diagnóstico , Eletrocardiografia , Sistema de Condução Cardíaco/fisiopatologia , Frequência Cardíaca , Síndrome do QT Longo/diagnóstico , Sindactilia/diagnóstico , Adolescente , Adulto , Transtorno Autístico/complicações , Transtorno Autístico/genética , Transtorno Autístico/fisiopatologia , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Parada Cardíaca/etiologia , Parada Cardíaca/fisiopatologia , Humanos , Lactente , Recém-Nascido , Japão , Síndrome do QT Longo/complicações , Síndrome do QT Longo/genética , Síndrome do QT Longo/fisiopatologia , Masculino , Fenótipo , Valor Preditivo dos Testes , Índice de Gravidade de Doença , Sindactilia/complicações , Sindactilia/genética , Sindactilia/fisiopatologia , Fatores de Tempo , Adulto Jovem
4.
Intern Med ; 59(1): 83-87, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31484910

RESUMO

Mutations in the cardiac sodium channel SCN5A can cause phenotypic overlap syndrome of long QT syndrome and Brugada syndrome. However, Brugada-type ST elevations in patients with overlap syndrome are often concealed, which creates a diagnostic challenge. A 38-year-old man was admitted due to ventricular fibrillation (VF). The 12-lead electrocardiogram showed a prolonged QT interval and saddleback-type ST elevation. Pilsicainide administration induced coved-type ST elevation and VF triggered by a single premature ventricular contraction. A genetic analysis showed an SCN5A c.5350G>A p.E1784K mutation. The present case suggests the importance of a drug administration test being performed in the clinical management of overlap syndrome.


Assuntos
Antiarrítmicos , Síndrome de Brugada/diagnóstico , Lidocaína/análogos & derivados , Síndrome do QT Longo/diagnóstico , Fibrilação Ventricular/fisiopatologia , Adulto , Síndrome de Brugada/complicações , Síndrome de Brugada/genética , Síndrome de Brugada/fisiopatologia , Eletrocardiografia , Humanos , Síndrome do QT Longo/complicações , Síndrome do QT Longo/genética , Síndrome do QT Longo/fisiopatologia , Masculino , Mutação , Canal de Sódio Disparado por Voltagem NAV1.5/genética , Fenótipo , Fibrilação Ventricular/etiologia
6.
Circ Arrhythm Electrophysiol ; 12(10): e007213, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31610692

RESUMO

BACKGROUND: Long QT syndrome (LQTS) is caused by the abnormal function of ion channels, which may also affect atrial electrophysiology and be associated with the risk of atrial fibrillation (AF). However, large-scale studies of AF risk among patients with LQTS and its relation to LQTS manifestations are lacking. We aimed to assess the risk of AF and its relationship to the LQTS genotype and the long-term prognosis in patients with LQTS. METHODS: Genotype-positive patients with LQTS (784 LQT1, 746 LQT2, and 233 LQT3) were compared with 2043 genotype-negative family members. Information on the occurrence of AF was based on physician-reported ECG-verified events. Multivariate Cox proportional hazards regression analyses were performed for ages 0 to 60 and after 60 years (reflecting an early and late-onset of AF) to assess the risk of incident AF by genotype and the relationship of AF to the risk of cardiac events defined as syncope, documented torsades de pointes, and aborted cardiac arrest or sudden cardiac death. RESULTS: In patients followed from birth to 60 years of age, patients with LQT3 had an increased risk of AF compared with genotype-negative family members (hazard ratio=6.62; 95% CI, 2.04-21.49; P<0.001), while neither LQT1 nor LQT2 demonstrated increased AF risk. After the age of 60 years, patients with LQT2 had significantly lower risk of AF compared with genotype-negative controls (hazard ratio=0.07; 95% CI, 0.01-0.53, P=0.011). AF was a significant predictor of cardiac events in patients with LQT3 through the age of 60 (hazard ratio=5.38; 95% CI, 1.17-24.82; P=0.031). CONCLUSIONS: Our data demonstrate an increased risk of early age AF in patients with LQT3 and also indicate a protective effect of the LQT2 genotype in it's association with a decreased risk of AF after the age of 60.


Assuntos
Fibrilação Atrial/etiologia , Eletrocardiografia , Síndrome do QT Longo/complicações , Adolescente , Adulto , Idoso , Fibrilação Atrial/genética , Fibrilação Atrial/fisiopatologia , Criança , Pré-Escolar , DNA/genética , Análise Mutacional de DNA , Canal de Potássio ERG1/genética , Seguimentos , Genótipo , Humanos , Lactente , Recém-Nascido , Canal de Potássio KCNQ1/genética , Síndrome do QT Longo/genética , Síndrome do QT Longo/fisiopatologia , Pessoa de Meia-Idade , Mutação , Canal de Sódio Disparado por Voltagem NAV1.5/genética , Fatores de Risco , Adulto Jovem
9.
PLoS Genet ; 15(8): e1008288, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31393878

RESUMO

Neuronal physiology is particularly sensitive to acute stressors that affect excitability, many of which can trigger seizures and epilepsies. Although intrinsic neuronal homeostasis plays an important role in maintaining overall nervous system robustness and its resistance to stressors, the specific genetic and molecular mechanisms that underlie these processes are not well understood. Here we used a reverse genetic approach in Drosophila to test the hypothesis that specific voltage-gated ion channels contribute to neuronal homeostasis, robustness, and stress resistance. We found that the activity of the voltage-gated potassium channel seizure (sei), an ortholog of the mammalian ERG channel family, is essential for protecting flies from acute heat-induced seizures. Although sei is broadly expressed in the nervous system, our data indicate that its impact on the organismal robustness to acute environmental stress is primarily mediated via its action in excitatory neurons, the octopaminergic system, as well as neuropile ensheathing and perineurial glia. Furthermore, our studies suggest that human mutations in the human ERG channel (hERG), which have been primarily implicated in the cardiac Long QT Syndrome (LQTS), may also contribute to the high incidence of seizures in LQTS patients via a cardiovascular-independent neurogenic pathway.


Assuntos
Proteínas de Drosophila/genética , Resposta ao Choque Térmico/genética , Canais de Potássio de Abertura Dependente da Tensão da Membrana/genética , Convulsões/genética , Regulador Transcricional ERG/genética , Animais , Animais Geneticamente Modificados , Drosophila , Proteínas de Drosophila/metabolismo , Técnicas de Silenciamento de Genes , Incidência , Síndrome do QT Longo/complicações , Síndrome do QT Longo/genética , Neurônios/metabolismo , Canais de Potássio de Abertura Dependente da Tensão da Membrana/metabolismo , Genética Reversa , Convulsões/epidemiologia , Regulador Transcricional ERG/metabolismo
11.
Taiwan J Obstet Gynecol ; 58(4): 552-556, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31307750

RESUMO

OBJECTIVE: Patients with Long QT syndrome (LQTS) P may present with torsades de pointes, ventricular tachycardia (VT), or ventricular fibrillation (VF) and are at risk of sudden cardiac death. MATERIALS AND METHODS: A 38 y/o female patient with uterus myoma developed VF during laparoscopic assisted vaginal hysterectomy surgery. Defibrillation was delivered and the electrocardiogram (ECG) returned to sinus rhythm after CPR. RESULTS: Patient survived and implantable cardioverter-defibrillator was implanted and received beta-blocker therapy. ECG obtained in out-patient clinic still showed QT interval prolongation, but revealed no prolongation few months after persistent beta-blocker therapy. LQTS type 8 (CACNA1C E768del mutation) was identified by genetic DNA sequencing study. CONCLUSIONS: Patients with concealed LQTS may have normal QT interval unless exposing to stress or specific stimuli. Unexpected ventricular arrhythmia may happen during any medical management. We should avoid triggers of QT prolongation, and get familiar with management of the episode.


Assuntos
Morte Súbita Cardíaca , Cardioversão Elétrica/métodos , Histerectomia/métodos , Leiomioma/cirurgia , Síndrome do QT Longo/complicações , Neoplasias Uterinas/cirurgia , Adulto , Anestesia Geral/efeitos adversos , Anestesia Geral/métodos , Reanimação Cardiopulmonar/métodos , Desfibriladores Implantáveis , Eletrocardiografia/métodos , Feminino , Humanos , Laparoscopia/métodos , Leiomioma/complicações , Leiomioma/diagnóstico , Síndrome do QT Longo/congênito , Síndrome do QT Longo/diagnóstico , Prognóstico , Medição de Risco , Índice de Gravidade de Doença , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/etiologia , Taquicardia Ventricular/terapia , Resultado do Tratamento , Neoplasias Uterinas/complicações , Neoplasias Uterinas/diagnóstico
12.
Cardiol Young ; 29(5): 697-698, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31169106

RESUMO

The coexistence of long QT syndrome with 2:1 or complete atrioventricular blocks has been reported in the literature, but, to the best of our knowledge, this is the first pediatric case of long QT syndrome coexisting with first-degree atrioventricular blocks( 1 - 3 ).


Assuntos
Bloqueio Atrioventricular/complicações , Síndrome do QT Longo/complicações , Bloqueio Atrioventricular/diagnóstico , Eletrocardiografia , Humanos , Lactente , Síndrome do QT Longo/diagnóstico , Masculino
14.
Pharmacotherapy ; 39(6): 718-723, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31045258

RESUMO

INTRODUCTION: Oral azithromycin (AZM) has been shown to reduce airway inflammation and disrupt biofilm formation. However, chronic AZM therapy may result in QT interval (QTc) prolongation. OBJECTIVES: The goals of this study were twofold: (i) to characterize the risk of QTc prolongation in adult patients with cystic fibrosis (CF) receiving AZM and other potential QTc-prolonging agents, and (ii) to describe and capture the number of potential QTc-prolonging agents patients with CF are prescribed. METHODS: A retrospective study was conducted over a 3-year period in an adult CF center. QTc values were recorded from electrocardiograms. Univariate and multivariate analyses were conducted. Standard QTc prolongation definitions (males ≥ 450 msec, females ≥ 470 msec) were used. RESULTS: A total of 89 adult CF patient's records were reviewed. Sixty-eight patients received chronic AZM therapy. Two male patients had prolonged QTc, but only 1 received chronic AZM therapy. The median QTc interval between patients receiving and not receiving AZM was not significantly different (405 [interquartile range, IQR: 388-425] vs 394 [IQR: 384-413] msec, respectively, p=0.14). Also, the QTc interval for patients taking chronic AZM 500 mg Monday/Wednesday/Friday or 250 mg daily was not significantly different (401 [IQR: 383-419] vs 409 [IQR: 394-427] msec, respectively, p=0.48). When stratified by the number of QTc-prolonging medications (AZM vs no AZM), there was no significant difference in median QTc values between patients receiving zero to ≥ 5 QTc-prolonging medications. CONCLUSION: An association between chronic AZM therapy and longer QTc intervals or significant QTc prolongation was not shown.


Assuntos
Azitromicina/administração & dosagem , Azitromicina/efeitos adversos , Fibrose Cística/complicações , Fibrose Cística/tratamento farmacológico , Síndrome do QT Longo/induzido quimicamente , Síndrome do QT Longo/epidemiologia , Adulto , California/epidemiologia , Fibrose Cística/epidemiologia , Feminino , Humanos , Síndrome do QT Longo/complicações , Masculino , Estudos Retrospectivos
15.
Prog Cardiovasc Dis ; 62(3): 227-234, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31078562

RESUMO

Sudden cardiac death (SCD) accounts for 230,000 to 350,000 deaths per year in the United States. While many who suffer SCD possess underlying structural heart disease, inherited arrhythmia syndromes are also important contributors to SCD. In patients without structural heart disease, inherited arrhythmia syndromes are identified in >50% of the remaining patients. In this review, we will focus on the presentation and management of three major inherited syndromes that lead to SCD in patients without structural heart disease: long QT syndrome (LQTS), Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia (CPVT). All these syndromes can present in patients who are asymptomatic or, at the other extreme, with syncope and even SCD. LQTS syndrome and Brugada are the most common inherited arrhythmogenic syndromes, while CPVT is much rarer. Determining which patients need pharmacologic treatment and those who would benefit from more aggressive treatment such as sympathectomies and implantable defibrillators is not always clear.


Assuntos
Síndrome de Brugada , Morte Súbita Cardíaca/etiologia , Síndrome do QT Longo , Taquicardia Ventricular , Síndrome de Brugada/complicações , Síndrome de Brugada/diagnóstico , Síndrome de Brugada/terapia , Desfibriladores Implantáveis , Eletrocardiografia , Humanos , Síndrome do QT Longo/complicações , Síndrome do QT Longo/diagnóstico , Síndrome do QT Longo/terapia , Medição de Risco , Taquicardia Ventricular/complicações , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/terapia
16.
Am J Trop Med Hyg ; 100(2): 399-404, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30734694

RESUMO

This study compared the frequency of abnormal electrocardiogram (ECG) types between scrub typhus patient group and age- and gender-matched health checkup group and their associations with disease severity in scrub typhus patient. Demographic characteristics and ECG and laboratory findings of patients with scrub typhus admitted to Chosun University Hospital, and normal subjects visiting the hospital for health checkup from January 2008 to December 2012 were retrospectively studied. Electrocardiogram abnormalities at admission were observed in 72 of 165 (43.6%) scrub typhus confirmed patients. The following ECG abnormalities were observed: arrhythmic group (31 cases, 18.8%), ischemic change group (25 cases, 15.1%), prolonged QT group (32 cases, 19.4%).Compared with the age and gender-matched health checkup group, ECG abnormalities were more commonly observed in scrub typhus patient group (13.9% versus 43.6%, P < 0.001). In addition, when compared with the normal ECG group, scrub typhus in the abnormal ECG group showed greater disease severity and this phenomenon was particularly prominent in the prolonged QT group. Based on our study prolonged QT observed in approximately 20% of patients with scrub typhus, clinicians should pay additional attention to drugs that affect QT interval.


Assuntos
Arritmias Cardíacas/fisiopatologia , Síndrome do QT Longo/fisiopatologia , Isquemia Miocárdica/fisiopatologia , Tifo por Ácaros/fisiopatologia , Idoso , Arritmias Cardíacas/complicações , Arritmias Cardíacas/diagnóstico por imagem , Arritmias Cardíacas/microbiologia , Análise Química do Sangue , Estudos de Casos e Controles , Eletrocardiografia , Feminino , Humanos , Síndrome do QT Longo/complicações , Síndrome do QT Longo/diagnóstico por imagem , Síndrome do QT Longo/microbiologia , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/complicações , Isquemia Miocárdica/diagnóstico por imagem , Isquemia Miocárdica/microbiologia , Orientia tsutsugamushi/patogenicidade , Orientia tsutsugamushi/fisiologia , Estudos Retrospectivos , Tifo por Ácaros/complicações , Tifo por Ácaros/diagnóstico por imagem , Tifo por Ácaros/microbiologia , Índice de Gravidade de Doença
17.
Clin Med (Lond) ; 19(1): 80-81, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30651253

RESUMO

Prolonged QT syndrome precipitates cardiac arrhythmias such as torsades de pointes (TdP) resulting in cardiogenic syncope or sudden death. We report a case of prolonged QT syndrome caused by donepezil which resulted in a fall and hip fracture. In this case female sex, advanced age and diuretic use may have increased the risk of recurrent syncope and potential underlying TdP. Cessation of donepezil resulted in normalisation of the QT interval. This case highlights a lesser known side effect of this dementia drug. It also reminds us of the importance of taking a thorough drug history while considering potential drug toxicity/interactions as part of the comprehensive geriatric assessment.


Assuntos
Acidentes por Quedas , Donepezila/efeitos adversos , Síndrome do QT Longo/induzido quimicamente , Nootrópicos/efeitos adversos , Síncope/induzido quimicamente , Acidentes por Quedas/prevenção & controle , Idoso de 80 Anos ou mais , Doença de Alzheimer/tratamento farmacológico , Donepezila/uso terapêutico , Feminino , Humanos , Síndrome do QT Longo/complicações , Nootrópicos/uso terapêutico
18.
J Investig Med ; 67(2): 289-294, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30367011

RESUMO

Patients with chronic kidney disease (CKD) have a high risk of fatal arrhythmias. The extended severe corrected QT (QTc) interval is a hallmark of ventricular arrhythmias and sudden cardiac death. The objective of this study was to evaluate the prevalence of acquired long QT syndrome (aLQTS) in hospitalized patients with CKD and search for potential risk factors to improve clinical risk stratification in patients with CKD. Information about patients with CKD was retrospectively collected in our hospital between January 2013 and June 2017. The prevalence of aLQTS in different stages of CKD was evaluated. The common risk factors for QTc prolongation in patients with CKD were compiled, and multivariable logistic regression analysis was used to evaluate how each factor was related to aLQTS in CKD. A total of 804 patients with CKD (299 females, 37.2%) participated in our study. The prevalence of aLQTS among all 804 patients was 56.97%, and the prevalence of QTc prolongation (>500 ms) was 10.07%. Among the elderly, impaired kidney function, hemodialysis, low serum potassium and low left ventricular ejection fraction (LVEF) were associated with QTc prolongation in patients with CKD. The prevalence of aLQTS is much higher and increases with the decline of kidney function in hospitalized patients with CKD, which is related to older age, impaired kidney function, hemodialysis, serum potassium and low LVEF.


Assuntos
Hospitalização , Síndrome do QT Longo/complicações , Síndrome do QT Longo/epidemiologia , Insuficiência Renal Crônica/complicações , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco
19.
Clin Cardiol ; 42(2): 235-240, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30537240

RESUMO

BACKGROUND: Electromechanical (EM) coupling heterogeneity is significant in long QT syndrome (LQTS), particularly in symptomatic patients; EM window (EMW) has been proposed as an indicator of interaction and a better predictor of arrhythmia than QTc. HYPOTHESIS: To investigate the dynamic response of EMW to exercise in LQTS and its predictive value of arrhythmia. METHODS: Forty-seven LQTS carriers (45 ± 15 years, 20 with arrhythmic events), and 35 controls underwent exercise echocardiogram. EMW was measured as the time difference between aortic valve closure on Doppler and the end of QT interval on the superimposed electrocardiogram (ECG). Measurements were obtained at rest, peak exercise (PE) and 4 minutes into recovery. RESULTS: Patients did not differ in age, gender, heart rate, or left ventricular ejection fraction but had a negative resting EMW compared with controls (-42 ± 22 vs 17 ± 5 ms, P < 0.0001). EMW became more negative at PE (-89 ± 43 vs 16 ± 7 ms, P = 0.0001) and recovery (-65 ± 39 vs 16 ± 6 ms, P = 0.001) in patients, particularly the symptomatic, but remained unchanged in controls. PE EMW was a stronger predictor of arrhythmic events than QTc (AUC:0.765 vs 0.569, P < 0.001). B-blockers did not affect EMW at rest but was less negative at PE (BB: -66 ± 21 vs no-BB: -113 ± 25 ms, P < 0.001). LQT1 patients had worse PE EMW negativity than LQT2. CONCLUSION: LQTS patients have significantly negative EMW, which worsens with exercise. These changes are more pronounced in patients with documented arrhythmic events and decrease with B-blocker therapy. Thus, EMW assessment during exercise may help improve risk stratification and management of LQTS patients.


Assuntos
Arritmias Cardíacas/diagnóstico , Eletrocardiografia , Teste de Esforço/efeitos adversos , Exercício Físico/fisiologia , Frequência Cardíaca/fisiologia , Síndrome do QT Longo/fisiopatologia , Função Ventricular Esquerda/fisiologia , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/fisiopatologia , Ecocardiografia Doppler , Feminino , Seguimentos , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Síndrome do QT Longo/complicações , Síndrome do QT Longo/diagnóstico , Masculino , Pessoa de Meia-Idade , Prognóstico , Recuperação de Função Fisiológica , Volume Sistólico
20.
Pract Neurol ; 19(1): 56-61, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30323052

RESUMO

The diagnosis of epilepsy is incorrect in up to 20% of cases so should be revisited if attacks are not responding to treatment. We present a case of long QT syndrome that remained undiagnosed in the epilepsy clinic for 15 years until a near-fatal arrhythmia revealed the diagnosis and allowed effective treatment of her attacks. We hope this near miss raises awareness of long QT syndrome as a potentially fatal, rare but treatable condition that neurologists must consider in people with a label of refractory epilepsy. We provide practical pointers to increase the chance of early diagnosis and explore the impact of a late diagnosis for the patient and her family.


Assuntos
Erros de Diagnóstico , Epilepsia/diagnóstico , Síndrome do QT Longo/diagnóstico , Adolescente , Feminino , Humanos , Síndrome do QT Longo/complicações , Convulsões/etiologia , Síncope/etiologia , Adulto Jovem
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