A Case of Congenital Long QT Syndrome with Reccurent Syncope

Congenital long QT syndrome (LQTS) is a disease characterized by prolongation of ventricle repolarization and by the occurrence, usually during emotional or physical stress, of life-threatening arrhythmias that lead to sudden death in most symptomatic and untreated patients. Two variants have been initially identified:the original Jervell and Lange-Nielsen syndrome of congenital deafness and autosomal recessive inheritance, and the more frequent Romano-Ward syndrome of autosomal dominant inheritance. Evidence also shows that approximately 25 to 30% of the cases are sporadic with syncope and a prolonged QT interval but without showing evidence for familial involvement. Familial and sporadic cases have been grouped under the definition of congenital long QT syndrome. We experienced a case of congenital long QT syndrome in a 13-year-old female girl. She had episodes of recurrent syncope and QT interval prolongation(QTc=0.46sec) in electrocardiogram(ECG). The ECG of her mother showed QT interval prologation(QTc=0.46sec). After applying atenolol, the QT interval returned to normal range and syncope has not occurred. We report a case of congenital long QT syndrome with a brief review of related literatures.

A Case of Imported Falciparum Malaria in a child

Despite on-going efforts to control malaria, the rate of malaria has not decreased throughout the world. It was believed that endemic malaria had been eradicated in Korea since the end of the 1970s, however it reemerged from 1993 and has been increasing ever since. Besides endemic malaria, imported malaria is also increasing in Korea as the number of overseas travellers and foreign workers increases. We discovered malaria in a two-year-old child who visited Sierra Leone with his missionary father. The patient contracted malaria despite chemo-prophylaxis with chloroquine and was diagnosed as falciparum malaria by blood smear examination and IFAT. He successfully recovered after administraion of quinine and clindamycin without complication. However, the malaria did not respond quickly to chloroqine and Fansidar but a drug resistence test was not performed.