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Long QT syndrome 3(LQT3)

MedGen UID:
349087
Concept ID:
C1859062
Disease or Syndrome
Synonyms: LQT3; SCN5A-Related Romano Ward Syndrome
 
Gene (location): SCN5A (3p22.2)
 
Monarch Initiative: MONDO:0011377
OMIM®: 603830

Authors:
Alexander J Groffen  |  Hennie Bikker  |  Imke Christiaans   view full author information

Additional description

From OMIM
Congenital long QT syndrome is electrocardiographically characterized by a prolonged QT interval and polymorphic ventricular arrhythmias (torsade de pointes). These cardiac arrhythmias may result in recurrent syncope, seizure, or sudden death (Jongbloed et al., 1999). For a discussion of genetic heterogeneity of long QT syndrome, see LQT1 (192500).  http://www.omim.org/entry/603830

Clinical features

From HPO
Sudden cardiac death
MedGen UID:
38841
Concept ID:
C0085298
Pathologic Function
The heart suddenly and unexpectedly stops beating resulting in death within a short time period (generally within 1 h of symptom onset).
Syncope
MedGen UID:
21443
Concept ID:
C0039070
Sign or Symptom
Syncope is a syndrome in which loss of consciousness is of relatively sudden onset, temporary (usually less than 1 to 2 minutes), self-terminating, and of usually rapid recovery. Syncope leads to a generalized weakness of muscles with loss of postural tone, inability to stand upright, and loss of consciousness. Once the patient is in a horizontal position, blood flow to the brain is no longer hindered by gravitation and consciousness is regained. Unconsciousness usually lasts for seconds to minutes. Headache and drowsiness (which usually follow seizures) do not follow a syncopal attack. Syncope results from a sudden impairment of brain metabolism usually due to a reduction in cerebral blood flow.
Torsades de pointes
MedGen UID:
21214
Concept ID:
C0040479
Disease or Syndrome
A type of ventricular tachycardia characterized by polymorphioc QRS complexes that change in amplitue and cycle length, and thus have the appearance of oscillating around the baseline in the EKG.
Ventricular fibrillation
MedGen UID:
21844
Concept ID:
C0042510
Disease or Syndrome
Uncontrolled contractions of muscles fibers in the left ventricle not producing contraction of the left ventricle. Ventricular fibrillation usually begins with a ventricular premature contraction and a short run of rapid ventricular tachycardia degenerating into uncoordinating ventricular fibrillations.
Ventricular tachycardia
MedGen UID:
12068
Concept ID:
C0042514
Finding
A tachycardia originating in the ventricles characterized by rapid heart rate (over 100 beats per minute) and broad QRS complexes (over 120 ms).
Ventricular flutter
MedGen UID:
56266
Concept ID:
C0152173
Finding
A potentially lethal cardiac arrhythmia characterized by an extremely rapid, hemodynamically unstable ventricular tachycardia (150-300 beats/min) with a large oscillating sine-wave appearance.
Prolonged QTc interval
MedGen UID:
294666
Concept ID:
C1560305
Pathologic Function
A longer than normal interval (corrected for heart rate) between the Q and T waves in the heart's cycle. Prolonged QTc can cause premature action potentials during late phase depolarizations thereby leading to ventricular arrhythmias and ventricular fibrillations.
Hydrops fetalis
MedGen UID:
6947
Concept ID:
C0020305
Disease or Syndrome
The abnormal accumulation of fluid in two or more fetal compartments, including ascites, pleural effusion, pericardial effusion, and skin edema.
Non-immune hydrops fetalis
MedGen UID:
105327
Concept ID:
C0455988
Disease or Syndrome
Hydrops fetalis is a descriptive term for generalized edema of the fetus, with fluid accumulation in extravascular components and body cavities. It is not a diagnosis in itself, but a symptom and end-stage result of a wide variety of disorders. In the case of immune hydrops fetalis, a frequent cause is maternofetal incompatibility as in that related to a number of genetic anemias and metabolic disorders expressed in the fetus; in other instances, it remains idiopathic and likely multifactorial (summary by Bellini et al., 2009). Nonimmune hydrops fetalis accounts for 76 to 87% of all described cases of hydrops fetalis (Bellini et al., 2009). Genetic Heterogeneity of Hydrops Fetalis In southeast Asia, alpha-thalassemia (604131) is the most common cause of hydrops fetalis, accounting for 60 to 90% of cases. Almost all of these cases result from homozygous deletion of the HBA1 (141800) and HBA2 (141850) genes. A few cases have been reported that had 1 apparently normal alpha-globin gene, termed the hemoglobin H (613978) hydrops fetalis syndrome (summary by Chui and Waye, 1998). Other genetic disorders predisposing to NIHF include other congenital anemias, such as erythropoietic porphyria (e.g., 606938.0013), and many metabolic disorders, such as one form of Gaucher disease (e.g., 606463.0009), infantile sialic acid storage disease (269920), mucopolysaccharidosis type VII (253220), glycogen storage disease IV (232500), congenital disorder of glycosylation type Ia (212065), and disorders of lymphatic malformation (see, e.g., LMPHM1, 153100).

Professional guidelines

PubMed

Hermida A, Gourraud JB, Denjoy I, Fressart V, Kyndt F, Maltret A, Khraiche D, Klug D, Mabo P, Sacher F, Maury P, Winum P, Defaye P, Clerici G, Babuty D, Elbez Y, Morgat C, Surget E, Messali A, De Jode P, Clédel A, Minois D, Maison-Blanche P, Bloch A, Leenhardt A, Probst V, Extramiana F
Heart Rhythm 2024 Mar;21(3):313-320. Epub 2023 Nov 11 doi: 10.1016/j.hrthm.2023.11.007. PMID: 37956775
Bains S, Lador A, Neves R, Bos JM, Giudicessi JR, Cannon BC, Ackerman MJ
Heart Rhythm 2022 Jan;19(1):81-87. Epub 2021 Sep 16 doi: 10.1016/j.hrthm.2021.09.016. PMID: 34537410
Perry JC, Garson A Jr
Adv Pediatr 1989;36:177-99. PMID: 2675568

Recent clinical studies

Etiology

Fukuyama M, Ohno S, Ozawa J, Kato K, Makiyama T, Nakagawa Y, Horie M
Circ J 2020 Mar 25;84(4):559-568. Epub 2020 Mar 12 doi: 10.1253/circj.CJ-19-1101. PMID: 32161207
Yu S, Li G, Huang CL, Lei M, Wu L
Pflugers Arch 2018 Mar;470(3):461-469. Epub 2017 Nov 10 doi: 10.1007/s00424-017-2079-7. PMID: 29127493
Jeevaratnam K, Chadda KR, Salvage SC, Valli H, Ahmad S, Grace AA, Huang CL
Clin Exp Pharmacol Physiol 2017 Dec;44 Suppl 1(Suppl Suppl 1):38-45. Epub 2017 Sep 20 doi: 10.1111/1440-1681.12721. PMID: 28024120Free PMC Article
Page A, Aktas MK, Soyata T, Zareba W, Couderc JP
Heart Rhythm 2016 Jan;13(1):190-8. Epub 2015 Aug 31 doi: 10.1016/j.hrthm.2015.08.037. PMID: 26334569Free PMC Article
Paech C, Suchowerskyj P, Gebauer RA
Pediatr Cardiol 2011 Oct;32(7):1060-1. Epub 2011 Jun 29 doi: 10.1007/s00246-011-0037-2. PMID: 21713438

Diagnosis

Ali H, Lupo P, De Ambroggi G, Cappato R
J Cardiovasc Electrophysiol 2019 May;30(5):771-772. Epub 2019 Feb 5 doi: 10.1111/jce.13864. PMID: 30699239
Goto H, Takasugi N, Verrier RL, Kuwahara T
J Cardiovasc Electrophysiol 2013 Oct;24(10):1183-4. Epub 2013 Apr 30 doi: 10.1111/jce.12169. PMID: 23631359
Paech C, Suchowerskyj P, Gebauer RA
Pediatr Cardiol 2011 Oct;32(7):1060-1. Epub 2011 Jun 29 doi: 10.1007/s00246-011-0037-2. PMID: 21713438
Kehl HG, Haverkamp W, Rellensmann G, Yelbuz TM, Krasemann T, Vogt J, Schulze-Bahr E
Circulation 2004 May 11;109(18):e205-6. doi: 10.1161/01.CIR.0000128874.43908.CA. PMID: 15136511
Perry JC, Garson A Jr
Adv Pediatr 1989;36:177-99. PMID: 2675568

Therapy

Yu S, Li G, Huang CL, Lei M, Wu L
Pflugers Arch 2018 Mar;470(3):461-469. Epub 2017 Nov 10 doi: 10.1007/s00424-017-2079-7. PMID: 29127493
Mazzanti A, Maragna R, Faragli A, Monteforte N, Bloise R, Memmi M, Novelli V, Baiardi P, Bagnardi V, Etheridge SP, Napolitano C, Priori SG
J Am Coll Cardiol 2016 Mar 8;67(9):1053-1058. doi: 10.1016/j.jacc.2015.12.033. PMID: 26940925Free PMC Article
Page A, Aktas MK, Soyata T, Zareba W, Couderc JP
Heart Rhythm 2016 Jan;13(1):190-8. Epub 2015 Aug 31 doi: 10.1016/j.hrthm.2015.08.037. PMID: 26334569Free PMC Article
Paech C, Suchowerskyj P, Gebauer RA
Pediatr Cardiol 2011 Oct;32(7):1060-1. Epub 2011 Jun 29 doi: 10.1007/s00246-011-0037-2. PMID: 21713438
Kehl HG, Haverkamp W, Rellensmann G, Yelbuz TM, Krasemann T, Vogt J, Schulze-Bahr E
Circulation 2004 May 11;109(18):e205-6. doi: 10.1161/01.CIR.0000128874.43908.CA. PMID: 15136511

Prognosis

Winbo A, Earle N, Marcondes L, Crawford J, Prosser DO, Love DR, Merriman TR, Cadzow M, Stiles R, Donoghue T, Stiles MK, Hayes I, Skinner JR
Heart Rhythm 2020 Aug;17(8):1304-1311. Epub 2020 Mar 27 doi: 10.1016/j.hrthm.2020.03.015. PMID: 32229296
Fukuyama M, Ohno S, Ozawa J, Kato K, Makiyama T, Nakagawa Y, Horie M
Circ J 2020 Mar 25;84(4):559-568. Epub 2020 Mar 12 doi: 10.1253/circj.CJ-19-1101. PMID: 32161207
Ali H, Lupo P, De Ambroggi G, Cappato R
J Cardiovasc Electrophysiol 2019 May;30(5):771-772. Epub 2019 Feb 5 doi: 10.1111/jce.13864. PMID: 30699239
Jeevaratnam K, Chadda KR, Salvage SC, Valli H, Ahmad S, Grace AA, Huang CL
Clin Exp Pharmacol Physiol 2017 Dec;44 Suppl 1(Suppl Suppl 1):38-45. Epub 2017 Sep 20 doi: 10.1111/1440-1681.12721. PMID: 28024120Free PMC Article
Paech C, Suchowerskyj P, Gebauer RA
Pediatr Cardiol 2011 Oct;32(7):1060-1. Epub 2011 Jun 29 doi: 10.1007/s00246-011-0037-2. PMID: 21713438

Clinical prediction guides

Winbo A, Earle N, Marcondes L, Crawford J, Prosser DO, Love DR, Merriman TR, Cadzow M, Stiles R, Donoghue T, Stiles MK, Hayes I, Skinner JR
Heart Rhythm 2020 Aug;17(8):1304-1311. Epub 2020 Mar 27 doi: 10.1016/j.hrthm.2020.03.015. PMID: 32229296
Fukuyama M, Ohno S, Ozawa J, Kato K, Makiyama T, Nakagawa Y, Horie M
Circ J 2020 Mar 25;84(4):559-568. Epub 2020 Mar 12 doi: 10.1253/circj.CJ-19-1101. PMID: 32161207
Ali H, Lupo P, De Ambroggi G, Cappato R
J Cardiovasc Electrophysiol 2019 May;30(5):771-772. Epub 2019 Feb 5 doi: 10.1111/jce.13864. PMID: 30699239
Yu S, Li G, Huang CL, Lei M, Wu L
Pflugers Arch 2018 Mar;470(3):461-469. Epub 2017 Nov 10 doi: 10.1007/s00424-017-2079-7. PMID: 29127493
Mazzanti A, Maragna R, Faragli A, Monteforte N, Bloise R, Memmi M, Novelli V, Baiardi P, Bagnardi V, Etheridge SP, Napolitano C, Priori SG
J Am Coll Cardiol 2016 Mar 8;67(9):1053-1058. doi: 10.1016/j.jacc.2015.12.033. PMID: 26940925Free PMC Article

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