Whitaker John, Wright Matthew, O'Neill Mark
Department of Cardiology, St Thomas' Hospital, London, UK.
BMJ Case Rep. 2011 Apr 13;2011:bcr1120103519. doi: 10.1136/bcr.11.2010.3519.
A 32-year-old Spanish man presented to hospital after a second episode of syncope immediately following exercise. On admission, his vitals signs were stable and he had a regular heart rate of 60 bpm. ECG and transthoracic echocardiogram were normal. He completed 15 min of a BRUCE protocol exercise test. One minute and ten seconds into recovery, he lost consciousness. His ECG demonstrated sinus arrest with pauses of up to 5 s and subsequently junctional ectopy. After 38 s, his heart returned to sinus rhythm at a rate of 140 bpm and he regained consciousness. Vasovagal syncope following exercise in the absence of structural heart disease is uncommonly reported. When cases of exercise-related syncope in patients with structurally normal hearts have been reported, the typical patient is a young male who engages in physical training. Treatment strategies in patients suffering with vasovagal asystole are necessarily empirical, and careful judgement based on the specific features of the individual cases needs to be employed.
一名32岁的西班牙男子在运动后立即出现第二次晕厥，随后被送往医院。入院时，他的生命体征稳定，心率正常，为60次/分钟。心电图和经胸超声心动图均正常。他完成了15分钟的布鲁斯运动试验。恢复1分10秒时，他失去意识。他的心电图显示窦性停搏，停搏时间长达5秒，随后出现交界性早搏。38秒后，他的心脏恢复窦性心律，心率为140次/分钟，他也恢复了意识。在无结构性心脏病的情况下，运动后发生血管迷走性晕厥的报道并不常见。当报道结构正常心脏的患者出现与运动相关的晕厥病例时，典型患者是从事体育训练的年轻男性。血管迷走性心搏停止患者的治疗策略必然是经验性的，需要根据个别病例的具体特征进行仔细判断。
