title: Exercise-induced intraventricular obstruction in a child with near syncope and chest pain during exercise.
abstract: We report the case of a 10-year-old girl with two episodes of light-headedness and chest pain during exercise. She had an unremarkable clinical record, physical examination, ECG, and echocardiogram. Noninvasive ischemia tests were positive, but coronary angiography was normal. Exercise stress echocardiogram revealed an exercise-induced intra-left-ventricular obstruction with a peak gradient of 78 mmHg and replicated her symptoms. After starting beta-blocker therapy her clinical status improved and no residual obstruction was detected. The authors review this unsuspected clinical condition, seldom reported in the adult population and, to our knowledge, never before in a child.
authors.affiliation: Cardiology Department, Hospital Divino Espírito Santo, Rua Grotinha, 9500-370 Ponta Delgada, Portugal. arturlop@gmail.com
authors.forename: Artur
authors.initials: A
authors.lastname: Lopes
authors.forename: Carlos
authors.initials: C
authors.lastname: Cotrim
authors.forename: José D F
authors.initials: JD
authors.lastname: Martins
authors.forename: Fátima
authors.initials: F
authors.lastname: Pinto
mesh_terms: D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology*; D002648:Child; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D025401:Echocardiography, Stress; D015716:Electrocardiography, Ambulatory; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009200:Myocardial Contraction / Q000502:physiology*; D013575:Syncope / Q000150:complications* / Q000175:diagnosis; D014694:Ventricular Outflow Obstruction / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology