Paeds Cases · cardiology
Explain long-QT syndrome to a parent after a near-drowning — OSCE
OSCE communication and shared-planning station: explaining the diagnosis of long-QT syndrome to a parent after their child collapsed during swimming, the meaning of the QT interval, the beta-blocker treatment and lifelong follow-up, the implications for siblings and the family, and the restrictions on sport and medication, with empathy and honesty.
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You are the paediatric registrar. You have five minutes to speak with Mrs Patel, whose nine-year-old daughter Anika was admitted after collapsing during a school swimming carnival. Anika has been diagnosed with long-QT syndrome — her QTc is 520 milliseconds and her exercise-related collapse is consistent with an arrhythmic event. Mrs Patel saw the collapse and is frightened. She has two other children aged six and twelve, and she mentions she has "always fainted" herself. Explain what long-QT syndrome is in plain language, what happened during the collapse and whether it could have been fatal, what the treatment involves and whether it is safe, what the restrictions are, and what it means for the rest of the family. Answer her questions, check her understanding, and agree a plan. [1]
References4ShowHide
- [1]Schwartz PJ, Moss AJ, Vincent GM, Crampton RS Diagnostic criteria for the long QT syndrome. An update. Circulation, 1993.PMID 8339437
- [2]Abrams DJ, Macrae CA Long QT syndrome. Circulation, 2014.PMID 24709866
- [3]Moss AJ, Zareba W, Hall WJ, et al. Effectiveness and limitations of beta-blocker therapy in congenital long-QT syndrome. Circulation, 2000.PMID 10673253
- [4]Napolitano C, Priori SG, Schwartz PJ, et al. Genetic testing in the long QT syndrome. JAMA, 2005.PMID 16414944