title: Recurrent syncope episodes and exercise intolerance in hypertrophic cardiomyopathy combined with atrioventricular conduction disturbance.
abstract: A 30-year-old female patient with known hypertrophic cardiomyopathy (HCMP) was admitted for recurrent syncope episodes. Electrocardiogram (ECG) showed 2 : 1 atrioventricular (AV) block. Stress echocardiography with bicycle showed high grade AV block at high stage of the exercise associated with exercise intolerance and dyspnea. Twenty-four hour ECG monitoring also revealed high grade AV block and 1 episode of non-sustained ventricular tachycardia. Implantable cardioverter/defibrillator-pacemaker (ICD-P) was inserted. After implantation of ICD-P, conduction disturbance and exercise intolerance were improved. AV block is a rare complication HCMP. There are just a few case reports that present symptoms caused by conduction disturbance in HCMP. This case describes repeated syncope episodes and exercise intolerance caused by conduction disturbance during exercise in HCMP patient. For evaluating the cause of syncope in HCMP, stress echocardiography can be helpful to understand the probable mechanism of syncope.
authors.affiliation: Department of Cardiology, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Kyun Hee
authors.initials: KH
authors.lastname: Kim
authors.forename: Dong Heon
authors.initials: DH
authors.lastname: Yang
authors.forename: Chang-Yeon
authors.initials: CY
authors.lastname: Kim
authors.forename: Nam Kyun
authors.initials: NK
authors.lastname: Kim
authors.forename: Won Suk
authors.initials: WS
authors.lastname: Choi
authors.forename: Myung Hwan
authors.initials: MH
authors.lastname: Bae
authors.forename: Jang Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Hun Sik
authors.initials: HS
authors.lastname: Park
authors.forename: Yongkeun
authors.initials: Y
authors.lastname: Cho
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
keywords: Atrioventricular block; Hypertrophic cardiomyopathy; Stress echocardiography; Syncope