DIAGNOSING CATECHOLAMINERGIC POLYMORPHIC VENTRICULAR TACHYCARDIA
Case presented by:
Tracings shown in Figure 45.1 (pre-exercise test) and Figure 45.2 (during exercise) were obtained in a 16-year-old female with recurrent syncope. Physical examination, baseline ECG and echocardiogram are within normal limits.
Question No. 1: The most likely cause of this patient’s symptoms is:
A.Recordings show artifact and recurrent nature of symptoms suggests neurally mediated syncope.
B.Preexcited atrial fibrillation (AF).
C.Ventricular tachycardia (VT) secondary to hypertrophic cardiomyopathy (HCM).
D.Ischemia-induced VT.
E.Torsades de pointes secondary to congenital long QT syndrome.
F.Catecholaminergic polymorphic ventricular tachycardia (CPVT).
Figure 45.1 Patient’s baseline ECG before exercise in supine position.
Figure 45.2 Patient’s ECG during exercise test.
Discussion
Syncope and arrhythmias during exercise in young patients may be seen in a number of conditions, albeit all of them relatively uncommon.
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