[Catecholamine induced ventricular tachycardia: a cause of severe syncope during adolescence].
A 15-year-old female teenager had recurrent syncopes and had been unsuccessfully treated for 6 years for seizures and hysteria. Syncopes were always triggered by emotions, or efforts, but electrocardiograms were normal between the episodes. A 24-hour-monitoring during a syncope, and provocative tests (exercise testing and isoprenaline administration) showed severe ventricular arrhythmias with premature polymorphous beats, followed by ventricular tachycardia and then ventricular fibrillation. These "catecholamine-induced" ventricular tachycardias are very rare but are always fatal without treatment. Syncopes are stress-induced and the diagnosis is almost always delayed, because the patients have a normal electrocardiogram, with normal QT interval. The arrhythmia appears beyond a "threshold" sinus rate and is easily reproducible by exercise testing. Betablockers are the only efficient treatment to prevent sudden death.
Lévy
M
M
Département de pédiatrie, hôpital Necker/Enfants-Malades, Paris, France.
Villain
E
E
Philippe
F
F
Kachaner
J
J
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002395:Catecholamines / Q000009:adverse effects*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D013564:Sympathetic Nervous System / Q000503:physiopathology; D013575:Syncope / Q000188:drug therapy / Q000209:etiology*; D017180:Tachycardia, Ventricular / Q000188:drug therapy / Q000209:etiology*
D000319:Adrenergic beta-Antagonists; D002395:Catecholamines
Tachycardie ventriculaire catécholergique: cause de syncopes graves à l'adolescence.