• Pierluigi Marzuillo, Alessandra Benettoni, Claudio Germani, Giovanna Ferrara, Biancamaria D'Agata, and Egidio Barbi.
• From the *Department of Women and Children and General and Specialized Surgery, Seconda Università degli Studi di Napoli, Naples and †Institute for Maternal and Child Health-IRCCS, Burlo Garofolo, University of Trieste, Trieste, Italy.
• Pediatr Emerg Care. 2014 Apr 1;30(4):257-61.

AbstractAcquired long QT syndrome (LQTS) is a disorder of cardiac repolarization most often due to specific drugs, hypokalemia, or hypomagnesemia that may precipitate torsade de pointes and cause sudden cardiac death. Common presentations of the LQTS are palpitations, presyncope, syncope, cardiac arrest, and seizures. An abnormal 12-lead electrocardiogram obtained while the patient is at rest is the key to diagnosis. The occurrence of drug-induced LQTS is unpredictable in any given individual, but a common observation is that most patients have at least 1 identifiable risk factor in addition to drug exposure. The cornerstone of the management of acquired LQTS includes the identification and discontinuation of any precipitating drug and the correction of metabolic abnormalities, such as hypokalemia or hypomagnesemia. Most of the episodes of torsade de pointes are short-lived and terminate spontaneously. We propose a management protocol that could be useful for the daily practice in the emergency pediatric department to reduce the risk of acquired QT prolongation.

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