Long QT Emergency 

I want to post a little update to this patient. I am the Pediatric Cardiology fellow in the video. We have seen her in the office for a couple of follow-ups since. We also obtained copies of her genotype, which turns out to be LQT2, a defect with iKR. Some literature reports that patients with this type of Long QT find supplemental potassium beneficial. In addition to increasing her beta-blocker, we started her on 3meq/kg/day of oral potassium. She has had no further defibrillator events since.

I can't hear what anyone is saying with this loud background music.

I wish I could get CEUs for these. I learn so much. Thank you Doctor!

Damn what bar are they in ? DISCO NITE 😎😎

Wow, scary. Thanks for your comments.

AICDs amazing life-saving invention. My Dad would have died 12 years ago without it (and several times since). Hate when it "does it's job....but glad that it does"

In addition, her QTc on this EKG strip was about 550 ms. On potassium and increased beta-Blocker, her QTc has not normalized, but it has shortened to 500 ms. Keep in mind this syndrome has a 70% mortality rate in children if untreated. These patients (and families) are fascinating.

Yes, I agree. You can significantly prolong with just high flow NC oxygen.

thanks!

It really depends on how well they are perfusing with the tachycardia and that varies considerably. Once the heart stops or goes into ventricular fibrillation, hypoxia would probably be under a minute.

Will do. Thanks.

Not a heart transplant, but a pacemaker/defibrillator and medications.

Understood. That was a production oversight that we learned from. :)

Excellent presentation!

This is what was happening to my mom on Sept 28th 2014 she was having a prolonged QT from Methadone they gave her a hundred 20 mg at a fast rate of less than a month at 72 years old I gave her massive heart attack now she has an ICD defibrillator and is having about where her heart is doing the prolonged QT again and she seconds from being shocked. So she has a machine next to her bed that sends messages back to the cardiologists and they keep calling saying that she's seconds from being shocked they set up a catherization to explore her heart and didn't find anything wrong so we're pretty scared right now it's still happening and we don't know what to do.

Purchased music specifically for making videos.

Music makes this video impossible to be watched

Great video, Professional presentation, I like the hint of drama with that appropriate selection of background music, you should've taken it down a notch though!

My daughter has Long QT as well. She is on propanolol, has a defibrillator implanted & had her nerves snipped on left side. Her qt is 650!

Reminds me of a call I was on several years ago. I had a six year old male who had a syncopal episode. He was getting his hair cut and passed out. I can't remember if he had a hx of fainting spells. Makes me wonder about long QT syndrome.

Very interesting Video! Thanks for uploading.

Seems informational, but I can't really tell over the loud music!

It's "canned music". I don't know the name.

Very interesting, nice job.

I don't remember. Sorry!

Dr. Mellick, how well do pediatric patients with long QT and an implanted AICD usually do prognostically? Is life expectancy expected to follow that of the normal population? Thanks Allen, IM PGY-2

You can't hear shit with that idiotic background music! Who edits these things?!

My best friend has long qt and a pacemaker. Took a long time to get diagnosed. This video is my nightmare.

I love your videos! Please, though, decrease the volume of the music.

Wouldn't it also depend if there was preox (assuming ED arrest)? If you've got em on an NRB or NC with an adequete flow rate for long enough it may buy you a few minutes. Please correct me if Im wrong, like you said it completely depends on the PT.

informative but viewers may struggle to understand it due to your background noise.....

The worst thing about this condition is the damned medication

see is so cute!!!

did this girl come by ambulance

What is the music used in the beginning?

Canned music?

so zofran would be contraindicated in her.

this is horrifying. any sort of heart arrhythmia episode stresses me out so much. i just got ablated for wpw (apparently successful), but I had no idea there were so many other problems you can have with your heart, always makes me wonder what's going to happen next :| would this girl benefit from an ablation too or because its genetic this is a whole different problem? theoretically would a heart transplant help?

diagnosis: death