Prolonged QT

[beche de mer]

What to the diving docs think about a person diving with the condition "prolonged QT interval"?

Thanks

 

[sky50960]

People with this syndrome are susceptible to an abnormally rapid heart rhythm called Torsade des pointes. When this occurs, the heart muscle can't contract effectively, and the normal volume of blood is reduced to the body and the brain. If the brain is starved of oxygen, the person faints within seconds.
If the heart can't regain its normal rhythm, it may go into spasms that lead to a deadly arrhythmia called ventricular fibrillation. Without immediate emergency treatment, death follows within minutes.

People with this syndrome may show prolongation of the Q-T interval during physical exercise, intense emotion.

In one type of inherited long Q-T syndrome, the person is also deaf. Studies of otherwise-healthy people with LQTS indicate that they had at least one episode of blacking out (fainting) by the age of 10. The majority also had a family member(s) with a long Q-T interval. It should be emphasized that people with LQTS don't necessarily have a prolonged Q-T interval all the time. Thus, when they have an ECG (as during a routine physical examination), the Q-T interval may be normal.

So wath is the risck of sudden death????

 

[sky50960]

How is LQTS treated?

Treatment for LQTS may include lifestyle changes, medicines, or surgery.

Lifestyle changes

If you are active in competitive sports, talk to your doctor about how this may affect your condition. Often, once treatment in started, patients with LQTS can participate in recreational sports or other activities in moderation. If you have episodes of fainting while you exercise, you may want to think about exercising with a friend or a family member who can call for help if you need it.

Medicines

Medicines called beta-blockers are the most common type of medicine given to patients with LQTS. These medicines do not cure LQTS, but they have been shown to reduce the symptoms of LQTS for those who have them. Beta-blockers are also effective for patients who have been diagnosed with LQTS but do not have any symptoms. In these cases, doctors will most likely prescribe a beta-blocker to prevent the symptoms of LQTS.

Surgery

When LQTS causes uncontrolled ventricular fibrillation, you might need an implantable cardioverter defibrillator (ICD). An ICD is a device that sends an electric shock to your heart to restore a normal heartbeat. The device is placed under the skin of your chest or abdomen and is connected to leads, which are passed through your veins to your heart.

Thus i yhink if left untreated it can be a cause of sudden death by torsade de pointe. If Diving or intensive sport take medical advice...

 

[beche de mer]

I ask this question as a dive medical examiner who has just been faced with a person with this condition, wanting to do an open water course.

She is 58 years old and not particularly fit. I'm not sure what her motivation for diving is. She is treated with a low dose of a medication called metoprolol. (Beta blocker.)

My feeling is that I should not pass her as fit for compressed gas diving. But I haven't struck this particular one before and I'd be interested to hear the opinion of anyone with expertise.