[Perioperative acquired long QT syndrome: a case report]

Area of Science:

• Cardiology
• Anesthesiology
• Genetics

Background:

• Acquired long QT syndrome (LQTS) is a rare but serious condition associated with an increased risk of torsade de pointes and sudden cardiac death.
• Diagnosis is crucial, especially in patients with a genetic predisposition, as LQTS can be triggered by various factors, including common medications like antibiotics and general anesthesia agents.
• Patients typically present with a normal baseline QT interval, making diagnosis challenging.

Observation:

• A case report details a patient with no prior medical history who underwent emergency surgery for a peritonsillar abscess.
• During the perioperative period, the patient developed LQTS.
• This was evidenced by multiple episodes of torsade de pointes and subsequent cardiorespiratory arrest.

Findings:

• The case highlights that acquired LQTS can manifest unexpectedly, even in individuals without a known predisposition.
• Commonly used medications and surgical stress can precipitate LQTS and life-threatening arrhythmias.
• The patient's presentation underscores the importance of vigilant cardiac monitoring in susceptible individuals.

Implications:

• This case emphasizes the critical need for heightened awareness and proactive management of LQTS in clinical practice, particularly in surgical settings.
• Anesthesiologists and cardiologists must be prepared to diagnose and manage LQTS to prevent fatal outcomes.
• Further research into identifying at-risk populations and optimizing anesthetic protocols is warranted to mitigate the risk of sudden cardiac death.