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I'm not sure how screening with ECGs would help to find people at risk. As I understand it, many "normal" people have porlonged QTs and some people who have LQTS have "normal" or "gray area" ECGs. Am I missing something here?
ECG screening for athletes has been suggested because these people tend to push the limits on physical exersion, which as we know, is a trigger for events particularly in Long QT type 1 patients (the most common type of LQTS). You're correct that anyone can have Long QT, so I agree that screening should not be limited to competitive athletes only...every young person should have a screening ECG at some point in their school years. At what age and whether the screening needs to be repeated remain questions that only research can answer.
If an ECG shows anything abnormal, that person should have further testing. That testing may provide a diagnosis for an arrhythmia disorder or may show that there is nothing to be concerned about. It is true that a single ECG may be within normal range, and it is suggested in the literature that additional ECGs might be needed to rule in or out Long QT.
QT intervals change constantly, like a heart beat or blood pressure. It can be "normal" one minute, and "grey" then next. If you're in a "grey" area usually a stress-echo is done, to see how a athlete's heart reacts to stress. That's when they can more tell if there is a problem, related to exercise and long qt on any specific person
EKGs should be mandatory for all kids in school. A baseline EKG could be useful as time goes on and could help identify any problem BEFORE any gym classes or sports. My daughters are in college, and since their diagnosis their Electrophysiologist has been deciding on what activities with them they can do. They do exercise at the gym, but they must monitor themselves and not let their pulse go over 160 trying to keep no higher than 150. They do ballroom dancing, archery, and can play sports but no competition of any kind. Once they start keeping score and getting pushed in any way, they are to stop. Relaxed sports is how we define it. In addition to EKGs. a good family health history is essential for any child. Doctors need to key in on any families with histories of young sudden death (below age 50), including car accidents and drowings.
I was diagnosed with Long-QT (a QTc of 475) when I was 15. The doctor at the time said it was nothing to be concerned about. I have passed out several times (2-3 times) and blacked out (but not fallen over) numerous times as a result of stress, surprise, etc. My heart-rate would regularly and easily reach 180 just slow-swimming, but I was a competitive swimmer who would race... the heart-rate would easily go up to 230 or 240. Once, it went up to 260 when I simultaneously got the fastest time in a race I had ever aimed for (I pushed harder than ever). I never passed out in the pool, so I guess the doctors weren't concerned.
Should I be concerned? I am having the hardest time trying to get the records of my followup stress EKG (which they said consequently didn't show any sign of Long QT) and get ahold of the insurance company on what can be covered by a visit (and tests) to an EP.
Any suggestions? Once you've had any sort of Long-QT numbers over 440 (which I'm told is the safest, highest number), is it possible to really not have LongQT afterall?
Thanks.
The QTc is the measurement of the QT interval but interpreted by the computer hence the "c" at the end. I have taken numerous EKG's in the field (911 calls) and we recommend transport to Hospital >460.
Like mentioned previously above, it changes constantly depending on what your heart is doing at that exact time. Also most Cardiologists like to measure it themselves and don't go by the QT'c. If you are symptomatic then the numbers don't mean anything. You need to take care of those symptoms. Stress test that fall into "normal" parameters is a great sign. If a Cardiologist performed the test then they will determine if you need to see an EP and should refer you. Go to the office to get your records. Remember they're yours and you paid for them.
I Pray you don't have any heart problems and this is all FYI. Take care.
Hi... I was able to get a copy of that EKG (stress-test)... my heart rate was 180 with a QT-interval of .24? I was told the QTc meant the QT interval with a measure of the adjusted heartrate. Did I understand that wrong? Is it possible to have a long-qt interval without actually being in danger of having long-qt syndrome? There's no reason for it to be acquired, though, as my blood levels (in the same visit as the first EKG at QTc of 475) were perfectly normal (I've never really had a problem with health). I now have an EP cardiologist who performed another resting EKG... this time, it showed up as 466. They were concerned, but after the event monitor I've been using the last three weeks, they dismissed the long-qt interval from being a concern. I don't buy it, though. Should I be concerned? Do doctors usually measure an EKG differently than the computer? He mentioned that if he were to measure it, the numbers wouldn't come up so high... can that happen twice?
Thank you for the information and support! Looking forward to more feedback, as I am scared. :(
We have had similar experience with doctors diagnosing Long-QT in our family. My sister has a long QT and has fainted but was told at the time that she was not at risk for the syndrome. I have a normal QT and have never fainted, but the EP put me on medication anyway after looking at my sons and my fathers ECGs. We have all had numerous ECG/stress tests/event monitor etc. and have had different diagnosis from different Drs. After five years of back and forth we were finally confirmed of Long Qt with a genetic test, my two sons and I both have it. We live in Canada and were tested for free. My sister is also now considered positive without the genetic test, but because of MY positive test. We are really happy to finally have at least a few answers.
Don't be scared, the fact that you know even a little about this problem goes a long way in helping you make choices that will keep you safe. Keep asking questions and find Doctors that you feel comfortable with. Family history can play a huge role in diagnosis, so you may want to have family members go in for ECGs. In our case the EP sent us to a genetic specialist who compared the ECGs of all our family and he said we would be good candidates for the genetic test. That was a God send because before that we had been told that we were not at risk for the syndrome (despite several family members with prolonged QT), but we were still medicated "just in case". We feel much better now, knowing what we are dealing with.
Also, Yes, Cardiologists and EPs always correct the QT interval that the machine gives them. That is why it is important to have a Dr. "read" the ECG. They will also look for other signs of Long QT, for example, an unusual T-wave.
I hope all this helps! The more you can find out, the more pieces of the puzzle you can fill in, the better you will be able to manage this. This problem can be so stressful, but you are not alone. One good thing that has come of all this; my five year old wants to be an EP when he grows up. Good luck and God bless.
I just came across your reply re:Long Q-T.
I agree that this syndrome is more complex than it looks.
In preventing long Q-T(And Channelopathy i.e
arrythmias due to electrolytes imbalance),there are
few things to pay attention to.Avoid things that may induce it.Avoid caffein,certain medication and drugs
.If you take medications notorious to affect QT,check your E.C.G. more frequent.Check your pulse when you run or just exercise etc.Drink enough electrolytes,when exercizing.Be on the alert.
Is there a tool that enables it?,not yet.I am working on it.
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