Talk:Long QT syndrome
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Ideal sources for Wikipedia's health content are defined in the guideline Wikipedia:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Long QT syndrome.
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Contents
- 1 Drugs causing prolonged QT interval
- 2 Genetic Testing
- 3 Side effect of anti-psychotics
- 4 LQT2 Section, Grammar
- 5 Left Cardiac Sympathetic Denervation
- 6 Non-genetic causes
- 7 NEJM 2008
- 8 Comparison Picture
- 9 treatment
- 10 Potassium supplementation as a treatment - *no* evidence?
- 11 Inappropriate citation
- 12 Too technical?
- 13 Broken reference
- 14 External links modified
- 15 The "50% death rate" stat
Drugs causing prolonged QT interval[edit]
This list starting the LQTS page would in my opinion be better suited in a separate article, especially since the list should be much longer when updated. In stead there should be an appropiate link to the list in the aquired LQTS section
Genetic Testing[edit]
Genetic testing was discussed in JAMA on 21 Dec 05[1]. JFW | T@lk 21:55, 22 December 2005 (UTC)
Side effect of anti-psychotics[edit]
Side effect of anti-psychotics based on PI sheets for Haldol and Geodon. John Elder 02:17, 28 March 2006 (UTC)
LQT2 Section, Grammar[edit]
in the article http://en.wikipedia.org/wiki/Long_QT_syndrome, should the txt under LQT2, "are poised so drug binding to them will", be "drugs" or some gramatical change?
- I changed this to "a drug". 6/18/08
Left Cardiac Sympathetic Denervation[edit]
Left Cardiac Sympathetic Denervation is absent from the article. — C M B J 22:44, 17 December 2008 (UTC)
Non-genetic causes[edit]
I have removed a long list (unsourced) with conditions and states in which the QTc interval may be prolonged. They don't belong in this article, because they are not "syndromal". They need to be discussed in another article, either about QTc prolongation or TDP.
More common than the various congenital causes of long QT syndrome are acquired causes. They can be divided into two main categories - those due to disturbances in blood electrolytes and those due to various drugs:
- electrolyte disorders
- drug-induced
- Antiarrhythmic drugs
- Antihistamines
- Antibiotics
- Macrolide
- Certain Fluoroquinolone antibiotics
- Major tranquilizers (i.e. antipsychotics)
- Tricyclic antidepressants
- Gastrointestinal Motility agents
- Antipsychotic drugs
- Analgesics
Just as with the congenital causes of the Long QT syndrome, the acquired causes may also lead to the potentially lethal arrythmia known as Torsade de Pointes. Treatment is straightforward - replace any deficient electrolytes if present and stop any culprit drugs if the patient is using one (or more).
Given its relatively high frequency of use, its tendency for drug-drug interaction, and its inherent ability to prolong the QT interval, the macrolide antibiotic erythromycin is probably the most prevalent cause of acquired long QT syndrome. Indeed, use of erythromycin is associated with a rate of death more than double that of use of other antibiotics[1]
In addition to the two major categories listed above, it should be noted that there are also some miscellaneous causes of QT prolongation such as anorexia nervosa, hypothyroidism, HIV infection, and myocardial infarction.
Hope this is OK.
References
- ^ Ray WA, Murray KT, Meredith S, Narasimhulu SS, Hall K, Stein CM (2004). "Oral erythromycin and the risk of sudden death from cardiac causes". N. Engl. J. Med. 351 (11): 1089–96. doi:10.1056/NEJMoa040582. PMID 15356306.
-- JFW | T@lk 14:59, 14 February 2010 (UTC)
- QT interval sounds like the right place. JFW | T@lk 15:15, 14 February 2010 (UTC)
NEJM 2008[edit]
NEJM covered this in 2008 doi:10.1056/NEJMcp0706513 JFW | T@lk 12:53, 6 March 2011 (UTC)
Comparison Picture[edit]
could there be added a comparison picture of what a LQT looks like —Preceding unsigned comment added by 71.112.216.33 (talk) 17:08, 23 March 2011 (UTC)
treatment[edit]
What about using primidone as a treatment. It is mentioned in the primidone article that it has been used for this purpose.
AriaNo11 (talk) 18:11, 28 April 2011 (UTC)
Potassium supplementation as a treatment - *no* evidence?[edit]
It states that the use of potassium as a potential treatment is not evidence-based - I can understand this, but doesn't reference even an anecdotal reports of long QT going into remission after potassium supplementation, and/or in vitro studies of the effect of K supplementation on the functions of the various ion channels. I find it hard to believe there isn't *any* evidence whatsoever. — Preceding unsigned comment added by 98.223.232.121 (talk) 18:16, 30 January 2012 (UTC)
Inappropriate citation[edit]
Hi Editors,
Checked on citation #13, Challenges of Diagnosis of Long-QT Syndrome in Children, this article does not support the claim made, nor is the claim cited within the article, appears to be a mistaken citation. — Preceding unsigned comment added by 152.132.10.133 (talk) 18:41, 4 September 2015 (UTC)
Too technical?[edit]
The language here is fairly technical and given without context, and I believe it should be marked.learnergenius (talk) 03:58, 2 February 2017 (UTC)
Broken reference[edit]
The link in reference #2 is broken. Here's a link that works, but I don't know how to update it in the article. http://www.mdedge.com/ccjm/article/94949/cardiology/congenital-long-qt-syndrome-considerations-primary-care-physicians — Preceding unsigned comment added by Trogyssy (talk • contribs) 16:21, 15 February 2017 (UTC)
External links modified[edit]
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The "50% death rate" stat[edit]
A stat that says that 50% of untreated LQTS patients die within 10 years keeps getting republished. The citation keeps referring to an LQTS overview page from from the NIH. This page IS NOT original research. This stat has been floating around the Internet and is reposted often by hospitals, schools, and even the NIH. It is patently false without the word "symptomatic" or "of patients who have had an LQTS triggered cardiac episode".
This is as absurd as a claim that McDonalds hamburgers kill 50% of people within 10 years, because some study of morbidly obese people who died within 10 years found half ate McDonalds.
The original research is clear that this stat is for SYMPTOMATIC patients. Stop reposting this claim without context, even if the citation seems semi-reputable. Once a person has a cardiac episode and LQTS is discovered, if THOSE people are leaving untreated, they have the 50% odds of dying within 10 years. This is far different from the asymptomatic person who discovers it via genetic testing. There is absolutely no hard evidence or even plausible anecdotal evidence that this is the case.
Recent source correctly using context
BillySalon (talk) 19:16, 4 February 2018 (UTC)BillySalon
- Thanks for coming to talk finally. Please stop removing the NIH source and content based on it. If you believe the NIH has published incorrect information, please contact them and have it changed there. Thanks. Jytdog (talk) 21:48, 4 February 2018 (UTC)
- Thanks for bringing that ref. I fixed the issue that I think is concerning you in this diff. Please make sure that the body of an article is corrected before, or when, the lead is corrected. Jytdog (talk) 22:00, 4 February 2018 (UTC)
- The NIH is not a charity and but rather is the position of the largest health care institute in the world.
- The review states "Among patients who have experienced a LQTS-triggered cardiac event (arrhythmic syncope, arrhythmic syncope followed by seizures, or aborted cardiac arrest), the untreated natural history is grim, with >50% mortality at 15 years"
- The NIH says "More than half of the people who have untreated, inherited types of LQTS die within 10 years."
- Fairly inline with each other. Doc James (talk · contribs · email) 23:23, 4 February 2018 (UTC)
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