• Ketut Angga Aditya Putra Pramana Fakultas Kedokteran Universitas Mataram
  • Yusra Pintaningrum
  • Jatno Karjono
Keywords: LQTS; NSTEMI; torsades de pointes


We reported a 64-year-old woman was admitted to Emergency Department of dr.Soetomo hospital with fainting and previous chest discomfort, then we diagnosed this patient with Non ST Elevation Myocard Infarct, diabetes mellitus, hypertension stage II, and long QT syndrome (LQTS) with torsades de pointes episodes.  There are two important tests to determine LQTS, electrocardiogram (ECG) and a genetic test. Two kinds of LQTS, congenital LQTS is caused by mutations in genes coding, and acquired LQTS often is associated with drugs or metabolit abnormalities.  Myocardial ischemia could change QT interval regionally in the area of ischemia, and these changes are related to extent and severity of coronary atherosclerosis. There are two major treatment options for patients with LQTS, medications and ICD/pacemaker implantation. Beta-blockers are the drugs of choice.



1. Anonymous. Introducing Long QT Syndrome, 2005, available at:
2. Yilmaz R, Demirbag R, Gur M. The Association of QT Dispersion and QT Dispersion Ratio with Extent and Severity of Coronary Artery Disease. Blackwell Publishing. A.N.E. 2006;11(1):43-51
3. Pintaningrum, Y., and Pramana, K. A. Acquired long QT syndrome (LQTS) secondary to electrolyte imbalance: A case report. Advances in Health Sciences. 2021; 46; 253-257.
4. Antzelevitch C, Burashnikov A. Mechanisms of Arrhythmogenesis. In: Cardiac Arrhythmia: Mechanisms, Diagnosis & Management. Eds: Podrid PJ, Kowey PR. Lippincott Williams & Wilkins. Second edition, 2001, pp. 61-65
5. Kubota T, Shimizu W, Kamakura S, Horie M. Hypokalemia-Induced Long QT syndrome with an Underlying Novel Missense Mutation in S4-S5 Linker of KCNQ1. Journal of Cardiovascular Electrophysiology 2000;11(9);1048-1054
6. Schwartz PJ. The congenital Long QT syndromes from genotype to phenotype : clinical implications. Blackwell Publishing Ltd. The 2nd key symposium. Journal Of Internal Medicine 2006;259:39-47
7. Schwartz PJ, Priori SG. Newer Approaches to management of the Long QT Syndrome. In: Harrison’s Advances in Cardiology. Ed: Braunwald E. Chapter 61. 2003; pp. 393-8
8. Priori SG, Napolitano C. Genetics of Inherited Arrhythmias. In: Cardiovasclar Therapeutics: A companion to Braunwald’s Heart Disease. Ed: Antman. Third Edition. Saunders Elsevier, 2007; pp. 505-7
9. Schwartz PJ, Moss AJ, Vincent GM, Crampton RS. Diagnostic Criteria for the long QT syndrome. Circulation 1993;88:782-784
10. Abedin Z, Conner R. Ion, Channels, and Currents. In: Essential Cardiac Electrophysiology. Blackwell Futura, 2007; pp.6-20
11. Swanthon. Disturbances of Cardiac Rhythm. In: Pocket Consultant Cardiology. Fifth Edition. Blackwell Publishing,2003, pp.279-282
12. Abedin Z, Conner R. Ventricular Tachycardia and Ventricular Fibrillation. In: Essential Cardiac Electrophysiology, 2007; pp.132-201
13. Pratanu S. Konsep dasar elektrokardiografi. Dalam: kursus elektrokardiografi. Surabaya. 2000; hal 3-6
14. Aronson RS. Electrophysiologic actions of antiarrhythmic drugs. In: Textbook of Clinical Cardiology. Ed: Goldberger E. Mosby. Missouri;1982; pp.905-25
15. Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M. ACC/AHA/ESC 2006 Guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death –Executive summary. Circulation, 2006;114:1088-1132. Available at
16. Anderson J, Young L, Long E. Potassium and Health. Colorado State University Extension- Nutrition Resources. 2006;9355. available at Updated July 11, 2008
17. Murray F. Magnesium is important for heart health. Better nutrition (1989-1990); 1989. Available at:
18. Myerson. Magnesium maximizes heart health; magnesium appears to be essential for the integrity of the heart muscle. Better nutrition;1989, available at:
19. Nortwestern University. Nutrition Fact Sheet: Magnesium, 2007, available at:
20. Roden DM. Long-QT Syndrome. Massachussetts medical Society. N Engl J Med, 2008;358:169-76
21. Cannon CP, Braunwald E. Unstable Angina and Non-ST Elevation Myocardial Infarction. In: Braunwald’s Heart Disease: A textbook of cardiovascular medicine. Eds: Zipes, Libby, Bonow, Braunwald. Elsevier Saunders. 7 th Edition. ;1991, pp. 1243-79
22. Harmani K, Idham I, Irmalita, Karo SK, Soerianata, Tobing DPL. Tata Laksana Sindroma Koroner Akut tanpa ST-Elevasi. Perhimpunan Dokter Spesialis Kardiovaskular Indonesia;2004
Case Report