Abstract
Acquired long QT syndrome (aLQTS) can occur in up to one third of patients undergoing cardiac surgery and is often undisclosed. We present a case of a 55-year-old male patient admitted to our center for mitral valve replacement surgery, and, during the postoperative period, a long QT greater than 600 ms was confirmed and in the Holter monitoring Torsade de Pointes (TdP) was evidenced. The patient received appropriate medical treatment and was discharge in stable clinical conditions.
Highlights
Acquired long QT syndrome can occur in up to a third of patients undergoing cardiac surgery and is often unrecognized
Patient was discharged ten days after surgery and during a one-year follow-up evolved clinically stable with NYHA I functional class, sinus rhythm, normal QTc interval and caring not to use drugs that could potentially lengthen the QTc interval
Sometimes when the QTc is prolonged over 500 ms, it can trigger Torsade de Pointes (TdP) and ventricular fibrillation (VF)
Summary
Acquired long QT syndrome (aLQTS) can occur in up to a third of patients undergoing cardiac surgery and is often unrecognized. A prolonged QT greater than 500 ms implies high risk of triggering Torsade de Pointes (TdP), ventricular fibrillation (VF) and sudden death. A 55-year-old male patient with diagnosis of severe mitral regurgitation and paroxysmal atrial fibrillation (PAF) underwent mitral valve replacement due to evolving with dyspnea and progressive deterioration of his functional class with preserved ventricular function. On the fifth day after cardiac surgery, a Holter monitor was placed for sudden periods of palpitations and blurred vision. Patient was discharged ten days after surgery and during a one-year follow-up evolved clinically stable with NYHA I functional class, sinus rhythm, normal QTc interval and caring not to use drugs that could potentially lengthen the QTc interval
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