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What is Romano Ward Syndrome?: Causes, Symptoms, Treatment

What is Romano Ward Syndrome?

Romano Ward Syndrome is a condition that disrupts the normal rhythm of the human heart, often known as arrhythmia. Romano Ward Syndrome is also known as long QT syndrome. It is an abnormal heart condition that causes the cardiac muscle to respond longer than the usual recharge beats. Romano Ward Syndrome or Long QT syndrome indicates a specific pattern of heart that is detected with the help of an electrocardiogram (EKG or ECG). It is a kind of test that reads the electrical activity of the heart. People suffering from Romano Ward Syndrome or Long QT syndrome experience abnormally long intervals of QT in their heartbeat. Therefore, abnormalities in time that require recharging cause abnormal heart rhythms. Risk factors include fainting, cardiac arrest and sudden death.(1) However, in some cases, people suffering from Romano Ward Syndrome never experience any health problem.

Symptoms of Romano Ward Syndrome

Major symptoms of Romano Ward Syndrome include syncope (fainting) that forms during the period between newborn and middle age. In most cases, condition of Romano Ward Syndrome is experienced during the twenties. Gradually, the frequencies and severity of abnormal episodes decreases as the patient ages and grows toward middle age. After crossing 40 years, symptoms of Romano Ward Syndrome start decreasing.(1) Typical symptoms of Romano Ward Syndrome include syncope, presyncope which means that one feels that they would pass out without actually falling unconscious, and palpitations. These symptoms are all related to the onset of a particular ventricular arrhythmia.(2)

Causes of Romano Ward Syndrome

The most common causes of developing Romano Ward syndrome are mutations in SCN5A, KCNQ1, and KCNH2 genes. These genes are responsible for building proteins from channels that contain cell membranes. The positively charged atoms or ions like sodium and potassium are transported through the channels. Therefore, mutations in the genes cause alterations in the function and structure of the channels. This brings a change in the flow of ions from both in and out of the cells and thus causing disruption in the normal rhythm of the heart.

Diagnosis of Romano Ward Syndrome

Diagnosis is based on the symptoms, medical history, family history and conduction of the physical examination.(1) However, there are typical tests for proper diagnosis including:

  • Electrocardiogram: In every session of an ECG, the doctor attaches a number of sensors to the chest for detecting electrical activity. The timing and duration of your heartbeat are then recorded through the machine.
  • Holter Monitor: A portable ECG device used for recording the heart’s activity for an entire day.
  • Event Monitor to Diagnose Romano Ward Syndrome: A portable ECG device attached to the body for monitoring heart activity for a few weeks to months’ time.

Treatment of Romano Ward Syndrome

Treatment for Romano ward syndrome often include long term simple preventive measures. Depending on the situation, it may also include medications with cardiac sympathetic denervation surgery.(1, 2) A patient may even need to get an implant of a medical device like a defibrillator. The ultimate goal of the treatment is to prevent abnormalities of the heart and keep the patients away from the risk of sudden death.


Living with Romano Ward syndrome often brings lots of uncertainties and thus, people should stay away from things that trigger abnormal heart rhythms. One of the ways to handle emergency situations is to let people around you know that there could be chances that you may faint or your heart might stop beating suddenly due to the condition and what should they do during such a situation. One can also alternatively carry around a medical alert card or bracelet with the information mentioned on it. This will also help the healthcare professionals to be aware of the condition of Romano Ward Syndrome and provide the necessary treatment immediately.


Sheetal DeCaria, M.D.
Sheetal DeCaria, M.D.
Written, Edited or Reviewed By: Sheetal DeCaria, M.D. This article does not provide medical advice. See disclaimer
Last Modified On:October 5, 2020

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