Hidden Reason for Long QT

Abstract

Long QT syndrome either congenital or acquired is a fatal condition which unfortunately results in 'torsade de pointes' (TdP) type ventricular arrhythmia, recurrent syncopes and sudden cardiac deaths. The definite diagnosis is lifesaving in order to understand if there is predisposing factor or not. In acquired long QT syndrome ion channel disorder is secondary to metabolic disorder or drugs. Here we present 36 years-old woman patient hospitalized with congestive heart failure secondary to dilated cardiomyopathy. She experienced ventricular tachycardia (VT) episode under medical control, hypokalemia was thought to be the underlying cause. Her anamnesis deepened, surprisingly primary hyperaldosteronism appeared which was first diagnosed eight years ago. Mexsiletine treatment (group IB anti-arrhythmic drug) started with the purpose of preventing recurrent VT episodes after potassium replacement. Thoracoabdominal angiographic computerized tomography was performed to see development of the adenoma, subsequently patient was referred to general surgery department for advanced treatment.