Effort-induced syncopal episodes in a child with family history of sudden death

Dr. Raimundo Barbosa Barros
Dr. Raimundo Barbosa Barros

Case presentation

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.


  1. Which is the clinical diagnosis? And why?
  2. Which are the electrocardiographic diagnose during treadmill stress testing and isoproterenol infusion?

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Auspicios Institucionales
  • Sociedad Argentina de Cardiología
  • Federación Argentina de Cardiología
  • SIAC
  • Asociación Argentina de Cardiología
  • Latin American Heart Rhythm Society
  • Fundación Barceló - Facultad de Medicina