IGS, male, 11-year-old patient, student, born and living in Ubajara, Ceará, Brazil. Reason for the visit: fainting.
History of current disease:
- Report of 2 episodes of sudden loss of consciousness while doing physical exercise, with no prodromes. He recovers conscious after some minutes, with no complaints after the event.
- He was referred by the neurologist after the second episode of syncope.
- Referred to cardiological evaluation after normal neurological tests.
- The first episode was 2 years ago when he was playing soccer and the second 8 months ago, riding a bicycle.
Personal history:
- Previously healthy.
- He mentioned 2 previous episodes of passing out during physical activity.
- He denies using medication regularly
- He was born through C-section, in term, without problems during pregnancy.
Family history:
• His brother died at the age of 8, while doing physical exercise. Lab tests: normal.
Two-dimensional transthoracic echocardiography color Doppler: normal Electrophysiological study (EPS)
- It was not able to induce ventricular tachyarrhythmia after stimulation of the right ventricle.
- Triggered episode of polymorphic ventricular tachycardia with isoproterenol infusion.
Questions
- Which is the clinical diagnosis? And why?
- Which are the electrocardiographic diagnose during treadmill stress testing and isoproterenol infusion?