Living with Lown-Ganong-Levine Syndrome (LGL)

About two years ago, I began to experience prolonged periods of intense dizziness.This continued over a period of months, and ultimately progressed to the point where I was in a constant state of dizziness.At the time, I had never heard of the condition Lown-Ganong-Levine syndrome (LGL), but even if I had, I do not think that I would have suspected that I was living with the condition, and most likely had been since I was a young child.Lown-Ganong-Levine syndrome is a disorder of the electrical conducting system of the heart, which regulates the heartbeat. People with Lown-Ganong-Levine syndrome may experience arrhythmias, due to the abnormal heartbeats caused by a pre-excitation of the ventricles of the heart.This condition causes people living with Lown-Ganong-Levine syndrome to experience rapid heartbeats, heart palpitations, and blackouts.It is not uncommon for people to live with Lown-Ganong-Levine syndrome well into adulthood before any they experience any symptoms.In my case, the diagnosis was a complete surprise.During the investigation of some other, tangentially related, medical problems, I had had occasion to undergo an electrocardiogram (EKG) multiple times, and no cardiac disorders had ever been detected.Testing to determine the cause of my dizziness included thorough audiology and vestibular testing to check for inner ear abnormalities, an MRI of the brain to rule out brain tumor or lesions, blood work to check for vitamin deficiencies, and a thorough neurological work-up, all to no avail.The diagnosis of Lown-Ganong-Levine syndrome in my case came during a frightening incident when I was overcome by dizziness while driving.I was able to pull over and take myself to the emergency room of my local hospital, which was fortunately just around the corner from where I had pulled over.As a standard part of my work-up, an emergency technician performed an EKG on me.I remember laughing at him.“Honey,” I said, “my heart is just about the only part of my body that hasn’t been giving me any trouble, lately.”You could have knocked me over with a feather when the doctor came in and told me that he had an explanation for what had happened that day, that it could likely explain my prolonged bouts of dizziness, and that it was cardiac in nature.He had detected what is called a short PR interval in the readout of my EKG.The PR interval represents the time taken for the electrical impulse that causes the heart to beat to pass from the sinus node to the ventricles, initiating the heartbeat.Essentially, the short PR interval was causing my heart to beat too quickly, causing me to experience arrhythmias.It was recommended that I see an electro-physiologist, which is a cardiologist who specializes in the electrical conduction system of the heart.After a repeat EKG confirmed the short PR interval, my electro-physiologist ordered a cardiac ultrasound, a holter monitor, and a portable event monitor to check my heart and try to get more information about what was happening.After all the tests were completed, she determined that I was living with Lown-Ganong-Levine syndrome, and had probably had it for most of my life.I enquired about my previously normal EKGs, and she explained that a short PR interval is a difficult condition to determine, even by physicians, for someone who is not looking for it.It is likely that evidence of Lown-Ganong-Levine syndrome was apparent on my previous EKGs, but had been missed by my previous doctors.Living with Lown-Ganong-Levine syndrome is extremely manageable, now that I know what it is that I am managing.Although if left untreated, there is a very small chance of sudden cardiac death due to Lown-Ganong-Levine syndrome, due to ventricular fibrillation caused by non-uniform ventricular activation rates, this is not a concern that I worry about.Accustomed to vigorous cardiovascular exercise, I reduced my exercise levels while adjusting to the addition of a beta-blocker medication, which helps to regulate my heart rate.Within a few days, my dizziness subsided, and I was able to reintroduce cardiovascular exercise, at a slightly lower intensity, back into my daily routine.It has been about a year since my diagnosis of Lown-Ganong-Levine syndrome.I continue to control the syndrome with beta-blockers, and am now back up to my previous levels of exercise.Aside from the occasional palpitations that I experience (usually when I forget to take my medication), I am symptom free.I was fortunate that Lown-Ganong-Levine was diagnosed in my case, and that it was done so before I suffered any significant consequences of the condition, or of the chronic dizziness that was affecting my stability and safety.

The electrical conduction system of the heart.

Credit: Kalumet

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