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LQT& or Andersen Syndrome Questions!!!!!

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ryanj0
ryanj0's picture
User offline. Last seen 1 year 24 weeks ago. Offline
Joined: 03/18/2009
Posts: 1
Hello,       Let me tell a little history about myself.  At the moment, I am a 20 year old male and think I may have ATS, a rare form of long qt syndrome as I understand it.  I was looking for some information to see if anyone has ever had anything similar to what I am about to describe or if it fits in with ATS and is something I should pursue.  I have an electrophysiologist that I trust, however, given as it is so rare, I wonder if it might not have occurred to him or maybe he doesn't know enough about it to propose it.  I will be going to Mayo April 6th, but want to know from people who know about ATS or have had it whether it is something that would be advised to bring up with them.  I realize anything you say is not medical advice or a diagnosis.  Now on to the history.        Around mid year 2007 I presented into the ER with an episode of syncope.  It was then found out that the my QTc interval was something like 520ms.  This was said to be caused by a medication I was taking which was immediately stopped.  My qtc dropped down to a decent rate and I was asked to wear a holter.  Nothing was abnormal with the holter.  Several more times in late 2007 and mid 2008 I presented with muscle weakness in the legs.  My qtc was usually on the higher end of normal to borderline and would sometimes be accompanied by hypokalemia, sometimes not.  In March of 2008, I passed out again, qtc was borderline so they implanted a Medtronic Reveal DX Implanted Loop Recorder.          Up to this point, all they had seen was sinus tachycardia and sporradic qt prolongation but nothing that happened all of the time.  The monitor is set to auto record any time my heart goes above 175 for 24 beats or more.  I can also auto record it.  It did, quite often record sinus tach anywhere up to 212 bpm.  No ventricular tachycardias were ever seen, which means, if present, would have been asymptomatic.  Fast forward to Feb 2009 (this year),  I start having unexplained hypokalemia.  My potassium will randomly, within hours, drop from a good range to critical, and it has been seen.  With the potassium dropping, I get muscle weakness.  Later on in the month I notice partial facial paralysis and muscle weakness in the legs.          When this muscle weakness happens and periodic facial paralysis, my potassium is sometimes low, sometimes not.  My qtc is usually between 420-480.  Then they start seeing pvc's and also ventricular tachycardia that lasts about 4 seconds.  I also have a scoliosis.  Fast forward to Friday, March 13, 2009.  I went into the ER with muscle weakness and sporadic cramping in the legs.  My potassium was at 3.7 (which is good) and my qtc was at 450 ms which is borderline I guess.  They send me home.  On Monday, the 16th, I follow up with my EP and my qtc is 502 ms.  I was having periodic facial paralysis and muscle weakness throughout the day.  My EP doc said he does not know what caused the qt to prolong that much in 3 days.  I was once on Sotalol 160 mg twice a day and that did not seem to upset the qt, and he said he doesn't know of any syndrome that can cause it to prolong that rapidly.             In between friday and monday I took nothing but my usual potassium chloride.  I was told potassium chloride cannot prolong the qt.  My potassium level was checked on the spot and it was 4.4 (best it's ever been).  Now fast forward one day to today.  I notice the facial paralysis and weakness in the legs so I go into the urgent care to see if there's a correlation.  My qtc was 526.  Given as my EP sent me home the day before, they did as well.  So, right now I am looking at sporadic prolongation of the qt interval, hypokalemia, facial paralysis, vtach, and pvc's all with no discovered cause by the docs I have seen.                      These all seem to fit together in ATS, but are they usually this sporadic??  With ATS, can the qtc be fine one day and prolonged a few days later??  The doc said that I did not have a qt syndrome on the basis that my implanted loop recorder has not auto recorded anything, but can this be an accurate diagnostic tool??  I have heard that vtach with ATS doesn't usually go above 150 bpm, so could it be asymptomatic (outside of my usual, still unexplained syncope) and not fast enough or long enough for the monitor to record??  I am just wondering, given what I have told you, if there are any docs on here that could advise whether this would be something for Mayo to look into while I'm there or for patients with ATS to let me know if it has been so sporadic for you.  I do seem to have a slight curvature on one finger on each hand (same finger), a narrow jaw, and have a scoliosis.  Please, any info would help.  Thanks and have a great day!!     P.S.  One doc did mention ATS but didn't know enough about it.  Family history is unknown on my father's father's side as he left before my dad was born.