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Medical Edge Newspaper Column from Mayo Clinic

SON’S SUDDEN DEATH LEAVES MOM WORRIED ABOUT HER OTHER CHILDREN

DEAR MAYO CLINIC: My son never had any signs of illness other than febrile convulsions when he was 1 year old and again when he was 4, but he died from a sudden episode of cardiac arrhythmia after playing chase eight years ago, when he was 6. I then made sure that my other two children received electrocardiograms and echocardiograms, and they came out fine.

But recently my daughter, who is now 11, has been complaining of dizziness. She has never fainted or lost her breath, but she does get dizzy sometimes when she exercises. Do you think that long QT syndrome could have caused my son’s death — it was never really explained — or that this is something I should be getting my daughter tested for? — Michigan

ANSWER: First let me say that I am terribly sorry about your son’s tragic death. As director of Mayo’s Long QT Syndrome Clinic, I have cared for many families who have shared your profound loss. And while I am beginning to imagine its depth, someone outside the family can never fully appreciate it.

With respect to the possibility that long QT syndrome was the cause of your son’s death: it is unlikely, given the history presented. Febrile convulsions are not a symptom of the syndrome and he did not exhibit the classic symptoms. I presume that a careful and complete autopsy was performed, and that the maddeningly vague diagnosis of “sudden episode of cardiac arrhythmia” was the only possible conclusion because nothing structural was found at autopsy.

Under such circumstances, the possibility of LQTS (“QT” refers to the length of time it takes cells in the heart’s lower chambers to electrically recharge between beats), or some other genetic heart-rhythm disturbance, is sometimes raised by default, even if the patient’s history fails to support it.

Studies have suggested that potentially inherited heart conditions can be found in about 25 percent of families that have an unexpected and unexplained death. With LQTS in particular, the heart has an electrical glitch in its recharging system that results in fainting spells, seizures or sudden death. The fainting spells, which are the main symptom, tend to be abrupt; and they are often triggered by physical exertion, emotional excitement (anger or fright, for example), or a startling noise (such as an alarm clock going off or a phone ringing). It is estimated that LQTS affects one in every 3,000 to 5,000 people in the United States.

Because dizziness is not a symptom of LQTS, your daughter’s current condition is not by itself a cause of worry. Nevertheless, given the family’s unfortunate history, you, your husband and children should periodically see a physician — preferably one with expertise in sudden death — in order to be carefully evaluated.

And if a family member should ever lose consciousness during physical exertion or emotional excitement, or after using a new drug, he or she should seek medical attention immediately.

— Michael Ackerman, M.D., Ph.D., Pediatric Cardiology and Cardiovascular Diseases,
Mayo Clinic, Rochester, Minn.

Additional Resources:
Long QT Syndrome
Appointment Information
More Information on Long QT Syndrome
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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.