HealthDay News — In the case of unexplained nocturnal enuresis, electrocardiography should be considered as part of the diagnostic workup, according to a creative concepts article published online April 6 in Heart Rhythm.

After reports of a case of a young adult with bedwetting, which ended in nocturnal sudden death, Ehud Chorin, M.D., from Sourasky Tel Aviv Medical Center in Israel, and colleagues surveyed family physicians and internists who are likely to encounter cases such as these to examine their familiarity with nocturnal arrhythmias as the underlying cause of bedwetting. Physicians were asked to select the diagnostic tests that they would perform in the case of a 20-year-old female with two episodes of unexplained bedwetting two years apart, with no other symptoms.

A total of 346 physicians responded to the survey; 114 were senior physicians with more than three years of experience. The researchers found that only four of the responders (1.1%) proposed performing an electrocardiogram as part of the workup, which was the only diagnostic test that was likely to identify the correct diagnosis in this case. There was no association seen for referral rates to electrocardiographic testing with responders’ medical specialty or level of experience. Overall, 19% of physicians mentioned that an encephalogram should be included in the diagnostic workup.

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“We are very surprised and extremely concerned by the lack of awareness among primary physicians about the possibility of nocturnal arrhythmogenic seizures caused by long QT syndrome,” a coauthor said in a statement.

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