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Exercise-induced syncope in a 22-year-old man
Colin Yeo1, Vern Hsen Tan1, Kelvin Ck Wong1
1Department of Cardiology, Changi General Hospital, Simei, Singapore.
A young man experienced syncope during exercise due to a sustained arrhythmia. Early identification via exercise stress testing is crucial for preventing sudden cardiac events.
Area of Science:
- Cardiology
- Sports Medicine
- Electrophysiology
Background:
- Syncope, or fainting, can be triggered by exertion in young athletes.
- Identifying the underlying cause of exercise-induced syncope is critical for preventing adverse cardiac events.
Observation:
- A 22-year-old physically active male presented with syncope during a sports activity.
- Initial investigations including ECG, echocardiography, and Holter monitoring were unremarkable.
- A treadmill exercise stress test revealed a sustained arrhythmia during stage 4 of the Bruce protocol, leading to syncope.
Findings:
- Exercise stress testing is a valuable diagnostic tool for identifying exercise-induced arrhythmias.
- Sustained ventricular arrhythmias can manifest as syncope during physical exertion.
- A corrected QT interval of 400 ms at rest does not exclude exercise-induced arrhythmias.
Implications:
- This case highlights the importance of considering exercise stress testing in young individuals experiencing syncope during physical activity.
- Prompt diagnosis and management of exercise-induced arrhythmias can prevent potentially life-threatening cardiac events.
- Further research into the specific mechanisms of exercise-induced syncope is warranted.
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