Early repolarization electrocardiography pattern with unexplained syncope during training in a young black African non-elite athlete: an accidental finding?
Until recently it was generally thought that early repolarization is benign. But a recent article in the NEJM (Haissaguerre et al.) suggests that some persons with early repolarization may be at risk of life-threatening ventricular tachyarrhythmia. Unexplained syncope or sudden death occurs mostly during sleep. However, some cases of cardiac arrest during exertion have been reported. We report the case of a 39 year-old black African male with early repolarization pattern on electrocardiogram who regularly experienced dizziness (and one episode of transient loss of consciousness) exclusively while exercising. Detailed examination was normal. Under quinidine therapy, he experienced no further episodes. Increasingly reported cases of cardiac arrest in Africans, and significant prevalence of early repolarization in this population, have to be taken into account since the Haissaguerre et al. report. Further evidence of the lethal consequences of this syndrome are needed, bearing in mind that diagnostic tools for life-threatening arrhythmias are often scarce in sub-Saharan Africa.
Bonny
Aimé
A
Hôpital Européen Georges Pompidou, Service de Cardiologie, Paris, France. aimebonny@yahoo.fr
Ditah
Ivo
I
Amara
Walid
W
Hamdaoui
Brahim
B
Frank
Robert
R
Le Heuzey
Jean-Yves
JY
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology; D044383:Black People; D004562:Electrocardiography; D015444:Exercise; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011802:Quinidine / Q000627:therapeutic use; D013575:Syncope / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control
D000889:Anti-Arrhythmia Agents; D011802:Quinidine