Long QT and Thymoma

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Submitted by Dr T on February 5, 2012 – 6:46pm

Question: 
I am about to get a thymectomy due to suspected thymoma.Recently, the attacks of chest pressure/pain, rapid heart beat and sudden dizziness/nausea worsened and during the last one I was in patient and my right arm suddenly became very heavy, The ER doc was called. when he finally arrived I was already in recovery though I still had some symptoms. She did an ECG and said it was normal. Yesterday, I got the report which says: Likely still normal. There was “QT prolongation” but there was another value which should have been smaller than 170 so that ECG would have been considered as defintely abnormal.My value was 172.However, I wonder if te result had been clearly abnormal during the peak of the attack.Could this explain my heart issues? (heart function per se is fine as seen in heart ultrasound)  – as far as I have understood, in QT syndrome, there is no mechanical or functional problem with the heart per se, it’s rather an issue of the nerves/external innervation of the heart. Am I right??What could cause such a QT syndrome if I dont take any drugs? Could this be a effect of autonomic neuropathy? And could it have something to with the thymoma at all? ThanksSarah

Hi Sarah,
In patients with a thymoma, low calcium levels are occasionally associated with long QT. Treatment involves correcting abnormal calcium and resection of the thymoma. Otherwise, I cannot possibly make a diagnosis, thus can only provide you with information. That said, it is highly unlikely that long QT syndrome (a congenital illness) is an issue.
Hope this helps,
Dr T

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