QT Syndrome, Prolonged, Emergency Medicine

Jason A. Tracy Reviewed 06/2017
 


Basics

Description

A disorder of myocardial repolarization characterized by a prolonged QT interval on the electrocardiogram 
  • The pathophysiology is complex and incompletely understood:

    • Alteration in car...

Diagnosis

Signs and Symptoms

  • Palpitations

  • Light-headedness

  • Dizziness

History

  • Syncope

  • Near syncope

  • Seizure

  • Family history of syncope or sudden death

  • Congenital deafness

  • Medication use

Essential Workup

Cardiac moni...

Treatment

Pre-Hospital

  • Supplemental oxygen

  • IV access

  • Monitor

  • Stable patients with prolonged QT transported without intervention

  • Cardioversion for unstable patients with confirmed torsades de pointes

  • Magnesi...

Follow-Up

Disposition

Admission Criteria

  • Symptomatic prolonged QT

  • Syncope

  • Cardiac dysrhythmia

  • Possible cardiac or ischemic event

  • Metabolic abnormality

Discharge Criteria

Asymptomatic prolonged QT in consultat...

Pearls and Pitfalls

  • Suspect prolonged QT in patients with syncope

  • Prolonged QT is an independent risk factor for sudden cardiac death.

  • Correct electrolyte abnormalities and discontinue offending drugs i...

Additional Reading

  • Chugh  SS, Reinier  K, Singh  T, et al. Determinants of prolonged QT interval and their contribution to sudden death risk in coronary artery disease: The Oregon sudden unexpected de...

Codes

ICD9

426.82 Long QT syndrome 

ICD10

I45.81 Long QT syndrome 

SNOMED

  • 9651007 Long QT syndrome (disorder)

  • 442946007 Aquired long QT syndrome

  • 442917000 Congenital long QT syndrome

  • 373905003 Jervell and Lan...

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