QT-interval prolongation as a first presentation of myocardial infarction:Case Report

Introduction:Long QT-syndrome is a condition associated with long repolarization time. It has two types: congenital and acquired. Acquired prolong QT type is caused by some drugs or conditions. Long QT syndrome which is accompanied by fainting, seizure and sudden death. We intend to report a case of myocardial infarction (MI) with first presentation of QT-interval prolongation. Case Report:A 62-year-old Iranian woman without significant medical history, cardiac disease and medication was referred to our cardiac emergency department with acute severe burning retro- sternal chest pain. She did not have any ischemic heart disease risk factor (diabetes mellitus, hypertension, hyperlipidemia and smoking). She did not have any familial history of cardiac disease. Initial electrocardiography (ECG) demonstrated mild ST-segment coving and symmetric deep T wave inversions in anterior precordial leads and QT-interval prolongation (QTc =670ms) (Figure 1). Review of previous annually checkup ECGs performed by family physician showed normal QT-intervals. The patient admitted as high risk acute coronary syndrome and urgent angiography was performed 3 hours after admission as an early invasive strategy. Angiography showed critical stenosis of left anterior descending (LAD) artery and first diagonal bifurcation and percutaneous coronary intervention (PCI) was performed successfully (Figure 2). The following ECGs showed that QT returns to normal just after PCI (Figure 3). The patient survived and had a good outcome during follow-up.

کلیدواژه ها:

Myocardial infarction ، QT-interval prolongation