Could I have long QT?

[Peterthegreatworrier]

Hi.
This is the first health related worry I've decided to poast about in ages. Beware, this is kind of a complicated story.
At the end of last year, I was percribed flouroxitine for anxiety, but then started experiencing tachycardia which at its height reached over 200bpm!!! (I was then 17, so my sinus max would have been way under this). I was eventually taken to the hospital and went through a number of tests (ECG, echo, ect.), where nothing serious was detected and I was taken off the medication.
Just yesterday, I went to a psychiatrist for the first time and they suggested having more tests before prescribing me on anything else, which will include another ECG. Unfortunately, at the start of the session when I first mentioned the flouroxitine incident, he brought up checking my QT!!!:weep:
WHAT? Wouldn't the cardiologists have detected it when I was at the hospital and as an outpatient? If I have had long QT this whole time then I could have died in any sports events I've done before and after the incident!!!
I'm getting the tests today, and now I'm really anxious about it, that this will be where they discover I have a serious heart condition.
The one thing that is keeping me hopeful is that when I mentioned that I had had multiple ECGs (including one before the incident) which had come back normal he seemed to then think that long QT was unlikely.
I am still very stressed, and I leave in less than an hour. Can someone please offer me some reasurance before I go?
Regards, Peterthegreatworrier

[Lifelonganxiety!]

Your PSYCHIATRIST said it could be long QT? When they hadn't seen an ECG (or probably been qualified to comment on it even if they did).

That's very irresponsible of them to say that. Seriously, they can't come close to knowing.

You're getting checked today, leave it to the professionals but don't worry about what this guy said.

[2Anxious]

You don't have long QT syndrome. It is genetic or brought on by things like electrolyte imbalances or drug use. If you eat a normal diet you won't have electrolyte problems.

The chances of missing it on an ECG is small, the chances of missing it on several ECGs is not worth talking about.

[Peterthegreatworrier]

No, he's ok, really, but I just wish he didn't say that :winks:
Regards, Peterthegreatworrier

[rsanchez]

Like others have said, they would have caught this by now given that you've had numerous ECGs. I think you'll be fine.

[MyNameIsTerry]

Your PSYCHIATRIST said it could be long QT? When they hadn't seen an ECG (or probably been qualified to comment on it even if they did).

That's very irresponsible of them to say that. Seriously, they can't come close to knowing.

You're getting checked today, leave it to the professionals but don't worry about what this guy said.

From Peter's post it seems that the psychiatrist decided to check it to be safe and didn't imply be had this. It's common for anyone who prescribes antidepressants to do such checks since some meds carry higher risks to someone with such an issue. Before you start some meds they have to perform liver function tests but that doesn't imply you have a problem, only that they are doing the right thing to avoid aggravating an existing condition in someone who could have it.

He did say it sounded unlikely but perhaps wants to cover his back, ensure safety for the patient or both.

[Peterthegreatworrier]

Thanks for the replies while I was gone :welcome:
I'm actually feeling a lot better after that, and even more so after reading these.
Regards, Peterthegreatworrier

[yogibear]

Wow that guy actually is a ****. No wonder you are on here worrying, anyone else would be. I agree that it's very doubtful that you have this and would have been picked up in one of those ecgs. He was totally unprofessional saying that, especially to people likes who worry. Please tell him from me that he is a Dick with a capital D!! Let us know how he takes been called that but more importantly let us know when you get your results showing all is fine X

[MyNameIsTerry]

I've just read Peter's post a few times and I still can't see a psychiatrist actually saying he has Long QT Syndrome, only agreeing it is unlikely and wanting to do some tests before devising a plan for medication.

I've been on Citalopram, one of the meds that is known to cause added risk for people with Long QT and I didn't have a single test. My GP knows my history and at my age at the time you wouldn't expect something to be popping up out of noweher I guess. My current med is Duloxetine and again no tests despite the stated drug precautions being:


Monitor

Monitor BP before starting therapy and periodically during prolonged treatment. Monitor all patients for the emergence of agitation, clinical worsening, irritability, suicidality, and unusual changes in behavior, especially during the initial few months of therapy and when increasing or decreasing the dose. Monitor for the emergence of serotonin syndrome or NMS-like signs and symptoms. Monitor for possible sexual adverse reactions.

I even reported agitation to be told "it's your anxiety" when I had never had that symptom before!

Going back to Citalopram for a second, it was never tested on people with heart issues and such people were omitted from pre-marketing clinical trials but they did test people with ECG's who were involved to find no significant changes. Since then they found that going above 40mg per day did little more but substantially increased the long QT risk and this is why they stick below that level now.

Thats just a couple of examples of why testing might seen relevant to a psychiatrist.

The only difference I see with Peter is that he has had several relevant tests and nothing has been seen BUT has the psychiatrist actually seen Peter's medical records or is this what Peter has told him? If the latter, he has a patient who has reacted badly to Fluoxetine and complained about heart issues plus had interaction with cardiologists. What if Peter didn't tell him the full story and he dished out a med that caused a problem? He would then have to defend that in an inquiry, let alone the impact to the patient. Doctor's like to check with other medical professionals about these things or review the results themselves as opposed to trusting what a patient says. If I was taken to A&E for something and they gave me a load of tests I had the week before, they would still do them even if I said they had found nothing and the reason I was brought in was unlikely to have happened since in their opinion.