4,199
edits
Puzzle 2004 10 469 - Answer: Difference between revisions
Jump to navigation
Jump to search
m
no edit summary
m (New page: {{NHJ| |mainauthor= '''A.A.M. Wilde, T.A. Simmers''' |edition= 2007:4,157 }} Figure 1: ECG of the patient (on valproic acid).|thumb In the setting of ...) |
mNo edit summary |
||
| Line 23: | Line 23: | ||
acid was discontinued. Two years later she again had a typical syncope with apparently no specific trigger. Because the β-blocker had been used faithfully, an ICD was implanted. A few months later she suffered another syncope. Interrogation of the ICD revealed a rapid ventricular arrhythmia which was terminated by a successful defibrillation shock of 21.7 J (figure 3). | acid was discontinued. Two years later she again had a typical syncope with apparently no specific trigger. Because the β-blocker had been used faithfully, an ICD was implanted. A few months later she suffered another syncope. Interrogation of the ICD revealed a rapid ventricular arrhythmia which was terminated by a successful defibrillation shock of 21.7 J (figure 3). | ||
In conclusion, in families with a long-QT syndrome any potentially related symptoms and/or minor ECG abnormalities warrant further investigation. In this patient, at a considerable distance from the index LQT patient, the diagnosis was suspected on the basis of | '''In conclusion, in families with a long-QT syndrome any potentially related symptoms and/or minor ECG abnormalities warrant further investigation.''' In this patient, at a considerable distance from the index LQT patient, the diagnosis was suspected on the basis of | ||
history and discrete ECG abnormalities (figure 1). DNA analysis proved the familial genetic abnormality; the cause of the recurrent syncope was only proved after ICD implantation. | history and discrete ECG abnormalities (figure 1). DNA analysis proved the familial genetic abnormality; the cause of the recurrent syncope was only proved after ICD implantation. | ||