Long QT1 – avoid strenuous exercise and strenuous swimming
Long QT2 – less adrenergically mediated, avoid exposure to loud noises
(There may be overlap within each long QT type so the general advice is applied to all)
Diet – potassium rich foods encouraged and during periods of diarrhoea and vomiting electrolyte replacement is important
Implantable cardiac defibrillator – if survivor or prior cardiac arrest without reversible cause (not appropriate for Margaret as her LQTS is reversible).
Permanent Pacemaker for Long QT associated with bradycardia
Testing of family members for LQTS
Margaret’s trimethoprin therapy is discontinued and she is commenced on a beta-blocker. After 7 days in hospital she is discharged home.
Additional Information
The following publication provides evidence based guidelines for the management of LQTS:
Ref: European Society of Cardiology, 2015. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death.
Margaret is prescribed a beta-blocker. Beta-blockers cause an adrenergic blockade which decreases the effect of sympathetic stimulation of the heart. This diminishes the risk of cardiac arrhythmias. Beta-blockers have been shown to be effective in 70% of patients with LQTS.
