Patient presents with prolonged QT interval, diagnosed as Long QT Syndrome LQTS, based on ECG findings demonstrating a QTc interval exceeding 470 ms for males and 480 ms for females.  Symptoms potentially related to prolonged QTc, such as palpitations, syncope, presyncope, or seizures, were reviewed.  Family history of sudden cardiac death, long QT syndrome, or unexplained syncope was assessed.  Differential diagnosis considered other causes of QT prolongation including electrolyte imbalances hypokalemia, hypomagnesemia, hypocalcemia, medication-induced QT prolongation specifically focusing on QT prolonging drugs, and underlying cardiac conditions.  Electrolyte panel including potassium, magnesium, and calcium ordered.  12-lead ECG and cardiac monitoring performed to assess QT interval dynamics.  Echocardiogram ordered to evaluate cardiac structure and function.  Patient counseled on risk factors for torsades de pointes and advised to avoid QT prolonging medications.  Treatment plan includes addressing any identified underlying causes like electrolyte abnormalities and discontinuation or substitution of QT prolonging drugs.  Beta-blocker therapy considered for symptomatic patients or those with a history of cardiac events or high-risk genotypes if genetic testing is pursued.  Referral to cardiology and or genetic counseling for further evaluation and management of prolonged QTc and Long QT Syndrome is recommended.  Patient education provided regarding lifestyle modifications, including avoidance of strenuous exercise and triggers for syncope. Follow-up ECG scheduled to monitor QTc interval response to interventions.  ICD implantation will be considered based on risk stratification, which includes QTc duration, symptoms, family history, and genetic testing results.