Acquired QT prolongation associated with esophagitis and acute weight loss: How to evaluate a prolonged QT interval

J. J. Koch, C. J. Porter, M. J. Ackerman

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

When the physician is confronted with a patient having significant QT prolongation, it is critical to determine whether the patient harbors a genetic defect and a transmissible form of long QT syndrome (LQTS) or whether the QT prolongation has an acquired cause. The distinction has profound ramifications for the type of care provided to the patient and family. We report the case of a previously healthy 14-year-old boy who presented with a 10-day history of painful swallowing, a 10-lb weight loss, and chest pain. A 12-lead electrocardiogram (ECG) showed marked QT prolongation. Endoscopy and culture identified a Herpes simplex esophageal ulcer. After treatment with acyclovir, the patient recovered completely. Three weeks after the resolution of his symptoms and recovery from his acute weight loss, a follow-up ECG showed complete normalization of the QT interval. This case illustrates yet another potential mechanism for acquired QT prolongation. We also provide a diagnostic algorithm for the careful evaluation of a prolonged QT interval.

Original languageEnglish (US)
Pages (from-to)646-650
Number of pages5
JournalPediatric Cardiology
Volume26
Issue number5
DOIs
StatePublished - Oct 1 2005

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Keywords

  • Electrocardiography
  • Esophagitis
  • Long QT syndrome
  • QT interval
  • Torsades de pointes
  • Weight loss

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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