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Repetitive ventricular tachycardia in a syncopal child: Cause or incidental finding ?
Martial Massin1, Caroline Jacquemart1, Karim Khaldi1
1Division of Pediatric Cardiology, Queen Fabiola Children's University Hospital Free University of Brussels ULB, Brussels, Belgium.
Summary
Recurrent fainting in a teen was initially diagnosed as reflex syncope. However, exercise testing revealed nonsustained right ventricular outflow tract tachycardia, suggesting a link between the two conditions.
Area of Science:
- Cardiology
- Electrophysiology
- Pediatric Medicine
Background:
- Reflex syncope is a common cause of fainting, often triggered by emotional stress or exercise.
- Nonsustained right ventricular outflow tract tachycardia is an arrhythmia that can be asymptomatic.
Observation:
- A 15-year-old female experienced recurrent syncopal episodes over 7 years, triggered by exercise and emotional stress.
- Initial diagnosis was reflex syncope.
- Exercise testing provoked recurrent salvos of nonsustained right ventricular outflow tract tachycardia.
Findings:
- The patient's syncopal episodes were linked to both reflex syncope and right ventricular outflow tract tachycardia.
- Both conditions share similar triggering factors (exercise, emotional stress).
- Effective treatment and monitoring during syncopal events were crucial for accurate diagnosis.
Implications:
- This case highlights the importance of considering cardiac arrhythmias in patients with suspected reflex syncope, especially when triggered by exercise.
- Understanding the interplay between autonomic and cardiac mechanisms is essential for diagnosing and managing syncope in adolescents.
- Comprehensive diagnostic evaluation, including electrophysiological testing, may be necessary to differentiate or identify coexisting causes of syncope.
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