Saturday, August 25, 2018

Symptoms and Triggers #Meg'sLongQTJourney

This is the next installment of my Meg's Long QT Journey Series. To follow will be the symptoms and symptoms associated with Long QT Syndrome. To read from the beginning, click the links below:

1. The First Seizure
2. The Second Seizure
3. The Third Seizure
4. Getting the Diagnosis
5. What is Long QT?
6. Types and Genetics

  • Fainting
  • Seizures
  • Sudden Cardiac Arrest
These are the only and main symptoms of long qt syndrome. They can occur with very little to no warning; they can be brought on suddenly.

Long QT Faint vs Vanilla or Common Faint vs Other Faints
Long QT Faint:
  • a sudden drop or loss of consciousness 
  • the actual faint occurs in mere seconds
  • little to no warning that a faint will happen - won't last more than a second or two
Vanilla (or Common) Faint:
  • presents with warning signs
  • takes longer to actually lose consciousness
Vasovagal syncope is the most common cause of fainting. It occurs when there's a sudden drop in heart rate or blood pressure. It can be caused from: standing too long, being in an overcrowded environment, being overheated, dehydration, fatigue, stress, the sight of blood, etc. Symptoms usually involve dizziness, lightheadedness, feeling nauseous, blurry vision, paleness, and sweating.

And then there's POTS, which is also known as postural orthostatic tachycardia syndrome. A faint from this occurs from a lack of blood flow when a person goes from a reclining position to an upright or standing position too fast. It produces a rapid heartbeat and lightheadedness that can cause a person to faint. There are other symptoms of this, but I only wanted to mention the most common ones.

There are multiple reasons for seizures to occur: epilepsy, head injury/trauma, brain tumor, and for the sake of this, long qt syndrome.

A seizure happens when there is a lack of blood flow to the brain.

Long QT vs Epilepsy
When someone has a seizure, one word comes in mind: epilepsy. While epilepsy is the most common cause of seizures, it is not the only reason for seizures to occur, as I mentioned above. However, Long QT patients can often get misdiagnosed with epilepsy for this very reason. I had three tonic- clonic seizures, also known as grand mal. For me, I felt normal after coming around (the seizures lasted a few minutes and it took a few minutes for me to come to fully - I believe they would last 5-7 minutes) except for being fatigued. By the next day, I was fine in that regard.

Since fainting and seizures can occur from a number of things, it is crucial to get a thorough evaluation if you experience either a faint or a sudden onset of a seizure. When I was going through my seizures, the possibility of epilepsy came up after all three, more so after my second one. If it wasn't for my pediatric cardiologist after my third one, I could have been diagnosed with epilepsy myself.

Cardiac Arrest vs Heart Attack
The last symptom I'm going to mention is cardiac arrest. Cardiac arrest often gets mistaken for a heart attack, but there are difference between the two.

Cardiac Arrest:
  • electrical problem
  • occurs when the heart malfunctions and stops beating unexpectedly
  • Cardiac arrest is triggered by an electrical malfunction in the heart that causes an irregular heartbeat. With its pumping acting disrupted, the heart cannot pump blood to the brains, lungs, and other organs.
  • Seconds later, a person becomes unresponsive, is not breathing, or is only gasping. Death occurs within minutes if not treated.
  • It can be reversible if treatment is started within minutes. Proper treatment is CPR and the use of an AED, automatic external defibrillator. 
  • In some rare occurrences, the heart will return to its normal rhythm without intervention.
Heart Attack:

  • circulation problem
  • occurs when blood flow to the heart is blocked
  • A blocked artery prevents oxygen-rich blood from reaching a section of the heart. If the blocked artery is not reopened quickly, the part of the heart normally nourished by that artery begins to die.
  • Symptoms of a heart attack may be immediate, but more often symptoms start slowly and can persist for hours, days, or weeks before a heart attack. 
  • Unlike with cardiac arrest, the heart usually does not stop beating during a heart attack. 
  • Symptoms can be different for men and women and they include: chest pain or discomfort; shortness of breath; cold sweats; nausea/vomiting; back or jaw pain; or pain radiating down the arm, in particular the left arm, but can be either side.
  • The longer the person goes without treatment, the greater the damage.
Most heart attacks do not lead to cardiac arrest. But when cardiac arrest occurs, heart attack is often the common cause. Other conditions may also disrupt the heart's rhythm and lead to cardiac arrest.



In a previous post, I mentioned that there are three common types of Long QT Syndrome. I believe the triggers that will be brought up can be for any of the types. The triggers can cause irregular heartbeats or arrhythmias that result in the symptoms of Long QT

Long QT 1
  • physical exercise, particularly swimming
  • emotional stress
  • torsades de pointes, a fast heart rhythm caused by the ventricles, occurs more often in type 1
  • Patients with type 1 may have more arrhythmias that can cause symptoms, but the episodes usually stop on their own.
  • the symptoms/episodes are less likely to be fatal
Long QT 2
  • startle or surprise
  • sudden loud noises such as an alarm clock, car horns, a doorbell, or a siren
  • emotional stress
Long QT 3
  • rest
  • during sleep
  • arousal from sleep
  • Type 3 is often association with having bradycardia, or a slow heart rate, which cause the arrhythmia and symptoms to occur.
  • Patients with type 3 have fewer episodes of arrhythmia.
  • Symptoms/episodes are more likely to be fatal.
While type 3 can be more fatal and type 1 less fatal, all three of these types and the other genetic types can have sudden cardiac arrest and can be fatal. While not all triggers may be known, they share common ones. For instance, type 5 triggers are similar to that of type 1.

Triggers can overlap. For instance, someone with type 3 can experience symptoms during sleep and with startles. Likewise, someone with type 1 may experience symptoms from exercise and startles as well.

More information will be provided in later posts on how all this effects lifestyle, especially when it comes to sports and exercise. After all, it is still important to stay fit and healthy despite having a heart condition.


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