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RESEARCH PRODUCT

Exercise-Induced Sustained Ventricular Tachycardia without Structural Heart Disease: A Case Report

Justyna WatkowskaMichelle Audrey DarmadiHenock Saint-jacquesHanaa KhadraouiAlberto N RomeroBlanca SimonAxel Duval

subject

Tachycardiamedicine.medical_specialtyHeart diseaseHeart DiseasesIschemia030204 cardiovascular system & hematologyVentricular tachycardiaCoronary AngiographyAsymptomaticCoronary artery disease03 medical and health sciencesElectrocardiography0302 clinical medicineInternal medicinemedicineHumansmedicine.diagnostic_testbusiness.industryMagnetic resonance imagingGeneral MedicineArticlesMiddle Agedmedicine.disease030220 oncology & carcinogenesisCardiologyTachycardia VentricularExercise TestFemalemedicine.symptombusinessElectrocardiographyEchocardiography Stress

description

Patient: Female, 51-year-old Final Diagnosis: Ventricular tachycardia Symptoms: Chest pain • shortness of breath Medication: — Clinical Procedure: Treadmill stress echocardiogram Specialty: Cardiology Objective: Unusual clinical course Background: Exercise-induced ventricular tachycardia (VT) has been widely reported in patients with preexisting structural heart disease or underlying ischemia and is attributed to reentry tachycardia and abnormal automaticity. However, studies regarding exercise-induced VT in individuals without evident structural heart disease are still limited. Case Report: A 51-year-old woman came to our practice for a treadmill stress echocardiogram. The patient experienced only mild chest discomfort and was otherwise asymptomatic. Cardiovascular risk factors were significant only for obesity and positive family history of coronary artery disease in the mother. During the exercise stress test, the patient developed wide complex VT with multiple capture beats accompanied by nausea and dizziness, which lasted approximately 2 minutes before resolving spontaneously. Subsequent evaluation with magnetic resonance imaging, transthoracic echocardiography, and coronary angiography revealed an absence of apparent structural heart disease. Conclusions: Exercise-induced VT in the absence of structural heart disease, although rare, can pose a life-threatening event and requires different considerations for management. The benefits of currently available therapeutic options have yet to be elucidated for this subset of patients. Thus, we assert that there is a need for further investigation on the approach of exercise-induced VT in patients without structural heart disease.

10.12659/ajcr.928242http://europepmc.org/articles/PMC7736153