Young woman with repetitive syncopal episodes and strong family background

Dr. Frank G. Yanowitz
Dr. Frank G. Yanowitz

Case presentation

AK: 25 year old Caucasian woman

  • Extensive work up for recurrent syncope and exertional chest pain
  • 5 episodes over last 2 months
  • No prodrome or seizure activity
  • Somewhat related to exercise or sitting-to-standing
  • Family History: one cousin died (cardiac arrest) at age of 27; uncle died at age of 30, unknown cause
  • Transthoracic echo: normal RV and LV function; normal valves; LVEF: 65%
  • Treadmill stress echo: 11 METS exercise capacity; no arrhythmia, no ST-T abnormalities; normal wall motion
  • 30 day event monitor: one 11 beat irregular ventricular tachycardia;
  • CT angiogram: normal coronary arteries; Ca2+ score: ‘0’
    Note: Exercise capacity is reported in terms of estimated metabolic equivalents of task (METs). The MET unit reflects the resting volume oxygen consumption per minute (VO2) for a 70-kg, 40-year-old man, with 1 MET equivalent to 3.5 mL/min/kg of body weight.


    1. Which is the most probable clinical diagnosis? Why?
    2. What are the appropriate steps for the diagnosis?

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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