When should I refer a patient with Long QT Syndrome to a cardiologist for further evaluation and management?

A patient with suspected or diagnosed Long QT Syndrome (LQTS) should be referred to a cardiologist for further evaluation and management in several key situations:

• Urgent Referral (within 24 hours):
  • If a 12-lead electrocardiogram (ECG) shows evidence of a long QT interval (corrected QT more than 450 ms) ³. This is considered a "red flag" ³.
  • If the patient has experienced transient loss of consciousness (TLoC) and also has an ECG abnormality, including a long QT interval ³.
  • If TLoC occurs during exertion ³.
  • If there is a family history of sudden cardiac death in people aged younger than 40 years and/or an inherited cardiac condition ³.
  • If there is a history of syncope or near syncope ¹.
  • If palpitations are precipitated by exercise ¹.
• Routine Referral:
  • If a resting ECG shows an abnormality, other than second or third-degree atrioventricular block ¹.
  • If there is a family history of sudden cardiac death ¹.