Value of history-taking in syncope patients: in whom to suspect long QT syndrome?
Open accessAbstract
AIMS: Long QT syndrome (LQTS), a potentially fatal disorder, has to be distinguished from non-fatal conditions. Our aim was to investigate whether history-taking can be used in identifying patients likely to have LQTS. METHODS AND RESULTS: We compared the characteristics of a group of LQTS patients with syncope patients presenting at the emergency department (ED) and vasovagal patients younger than 40 years of age. Thirty-two LQTS patients were included. We included 113 patients at the ED and 69 vasovagal patients. Family history of syncope, sudden cardiac death, or cardiovascular disease was found more often in LQTS patients. Palpitations were the only symptom reported more often in this group. Syncope while supine, during emotional stress and associated with exercise was also more common among LQTS. Standing as a trigger was found more often in ED and vasovagal patients. CONCLUSION: We conclude that a family history for syncope and sudden cardiac death, palpitations as a symptom, supine syncope, syncope associated with exercise, and emotional stress place patients at higher risk for LQTS. These findings should alert physicians to the potentially life-threatening illness of LQTS, and act accordingly by obtaining an electrocardiogram and paying specific attention to the QT interval.
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Attention to triggers and presence of palpitations preceding syncope onset have been helpful in diagnosing an arrhythmic etiology.
“Attention to the triggers and presence of palpitations preceding syncope onset have been helpful in diagnosing an arrhythmic etiology (315).”
From 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (2017) · cites this paper as [315]
The Conclusion (page not available) reports that palpitations before syncope and certain triggers are more common in patients with long QT syndrome and warrant further cardiac testing. The Usefulness in daily clinical practice section says these triggers should alert physicians to possible cardiac syncope. The paper supports using these features to raise suspicion, but does not establish that they diagnose arrhythmic causes of syncope generally. (LLM, conf=0.84)
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Cites
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- Authors
- Colman, N., Bakker, A., Linzer, M., Reitsma, J. B., Wieling, W., & Wilde, A. A. M.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- University of Wisconsin–Madison (US)
- Corresponding author
- Wilde, Arthur A.M.
- Venue
- EP Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-05-29
- Volume
- 11
- Issue
- 7
- Pages
- 937-943
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2162798299
- Cited by
- 73
- References
- 6
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 2 · 2018: 8 · 2017: 10 · 2016: 4 · 2015: 6 · 2014: 6 · 2013: 6 · 2012: 2
- FWCI
- 6.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- long QT syndrome, syncope, vasovagal syncope, medical history, family history of sudden cardiac death, palpitations, exercise-induced syncope, emotional stress, emergency department patients, electrocardiogram, QT interval
- MeSH terms
- Adult, Female, Humans, Long QT Syndrome, Male, Medical History Taking, Middle Aged, Netherlands, Prognosis, Surveys and Questionnaires, Risk Factors, Sensitivity and Specificity, Syncope, Reproducibility of Results, Comorbidity, Incidence, Risk Assessment
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