Long QT Syndrome

Repolarisation

Recognition

  • QTc >450 ms (men), >470 ms (women); high risk >500 ms
  • Use Bazett: QT/√RR

Key findings

  • Macrolide/quinolone/methadone/antipsychotic association
  • Notched / broad T

Clinical importance

  • Risk of torsades de pointes / sudden cardiac death

Management pearls

  • Stop QT-prolonging drugs
  • Correct K⁺ ≥4.5, Mg ≥1.0
  • Magnesium 2 g IV for torsades
  • β-blocker / pacing / ICD for congenital LQTS
WardRound

WardRound

Clinical Decisions in Seconds