Sunday, July 29, 2012

Important Updates Concerning Prevention and Management of Sudden Arrhythmic Death Syndromes....



     Since the reason this blog exists at all is the sudden and unexpected death of our youngest son Daniel, presumably due to a sudden arrhythmic episode, in the absence of anything else of any significance found on his autopsy,  it makes sense to being our readership updates from medical literature concerning sudden arrhythmic death syndromes or SADS.   To refresh, there are a number of sudden arrhythmic death syndromes, the ones with which you are likely most familiar are Brugada Syndrome, and Long QT Syndrome,  Short QT Syndrome,  but there are others.
                According to recent information from the SADS Foundation, the newest recommendations are that people with Brugada Syndrome, particularly with the Brugada Syndrome  Type I EKG, should avoid the drug Procaine (which is an analgesic), as it has the potential to alter their EKG.  Procaine is added to other drugs sometimes, especially injectable antibiotics in order to diminish pain when given as an intramuscular injection.  Procaine and its related counterparts are also given during dental procedures.  Certainly, we cannot completely exclude the use of these substances for those with a prior history of rhythm disturbance, but we can make our dentists and other physicians aware of a familial history of rhythm disturbances and remind them when a patient with Brugada Syndrome or arrhythmic disorder history personally, comes to the physician or dentist.  It is recommended that caution and close supervision be undertaken when using these drugs on this particular patient population.
               Also, it now may be possible to diagnose Long QT or the proneness to it, in fetuses of a variety of gestational ages.  Children with fetal arrhythmias should be evaluated for potential Long QT syndrome by a pediatric cardiologist NO MATTER WHAT YOUR OBSTETRICIAN TELLS YOU. He or she might be an excellent obstetrician but may not be up to date on all the nuances of pediatric cardiology.   More information is available on this and a variety of aspects of prenatal Long QT diagnosis, in the second article below.

Daniel was twelve at his passing, and would be sixteen today.      Daniel had a prenatal arrhythmia (before he was born and during labor) which disappeared when he was born and his umbilical cord was clamped.  We were categorically told that no evaluation by a pediatric cardiologist was required, by both our obstetrician and our pediatrician.  Sixteen years ago, this was the conventional thinking.  They were wrong.



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    1. Dear Calm PRT Progonol, "What I Learned from Daniel" is the now four year journey in blog, of a family who has lost a child suddenly from supposedly, a lethal cardiac arrhythmia, when there were no abnormalities found on repeated autopsy attempts, at several major university centers. Over the last four years, we have examined multiple aspects of what happened here, the psychologic, the spiritual, and a variety of the medical aspects of this experience. As a college professor and an RN, I have discussed various aspects of arrhythmic disorders on blog. I suggest that you read more of the hundreds of posts which preceded this one, or simply run a search for the arrhythmia topic of your interest at the top of each "Learned from Daniel" page. However,most of all, "Learned from Daniel" tracks the spiritual and psychologic journey of the family who lost this valued person, it should not be employed as an authoritative source for information on arrhythmia diagnosis or treatment strategy. For this, the public should speak with their physicians, their cardiologists, or google their specific disorder or concern, where they will find tens of thousands of focused authoritative references on their subject. To do otherwise is a misuse of this site.


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