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Challenges in Clinical Electrocardiography
November 2014

Prolongation of a Prolonged QT: A Case of an Undiagnosed Congenital Long QT Syndrome

Author Affiliations
  • 1Department of Medicine, Mayo Clinic, Jacksonville, Florida
  • 2Division of Cardiovascular Diseases, Mayo Clinic, Jacksonville, Florida
JAMA Intern Med. 2014;174(11):1831-1833. doi:10.1001/jamainternmed.2014.4047

Several weeks after the birth of her first child, a woman in her 20s collapsed suddenly. She was found to be in ventricular fibrillation and was successfully cardioverted en route to her local hospital, where an amiodarone infusion was initiated. Discussion with the family revealed that she had a history of syncopal events, but each episode was self-limited, and therefore no workup was pursued. Family history was remarkable for syncope and seizures in a sibling. On examination, the patient was intubated and unresponsive to verbal or tactile stimuli. Cardiopulmonary examination revealed a regular rate and rhythm without murmurs, rubs, or gallops.