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Recurrent Cardiac Arrest With Negative Stress Test: An Unusual Presentation of Catecholaminergic Polymorphic

Ama K Annor1, Stephen A May2, Alexis M Fenton3

  • 1Department of Internal Medicine, Baylor College of Medicine, Houston, Texas.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

Catecholaminergic polymorphic ventricular tachycardia, a genetic disorder, typically presents with exercise-induced arrhythmias. This case highlights a rare variant with a normal stress test, challenging standard diagnostic approaches for this condition.

Area of Science:

  • Cardiology
  • Genetics
  • Electrophysiology

Background:

  • Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited arrhythmogenic disorder.
  • It is characterized by stress-induced ventricular tachyarrhythmias due to abnormal intracellular calcium handling.
  • Diagnosis commonly relies on exercise stress testing to provoke ventricular ectopy.

Observation:

  • This report details an unusual CPVT case.
  • The patient exhibited ventricular arrhythmias unrelated to physical exertion.
  • Crucially, the diagnostic exercise stress test yielded normal results.

Findings:

  • The case demonstrates a CPVT presentation atypical for exertion.
  • Standard diagnostic protocols may miss non-exertional forms of CPVT.
  • Genetic factors influencing calcium release are implicated.

Implications:

  • This case expands the clinical spectrum of CPVT.
  • Diagnostic strategies for CPVT may need refinement.
  • Further research into non-exertional triggers is warranted.

Keywords:
ARVC, arrhythmogenic right ventricular cardiomyopathyCPVT, catecholaminergic polymorphic ventricular tachycardiaECG, electrocardiographyICD, implantable cardioverter defibrillatorLQTS, long QT syndromePVC, premature ventricular contractionSCA, sudden cardiac arrestVF, ventricular fibrillationVT, ventricular tachycardiaWPW, Wolff-Parkinson-Whitebeta-blockerselectrophysiologyexercisegenetic disorderspalpitationsventricular fibrillation

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