Pérez-Riera Andrés R, Barbosa-Barros Raimundo, de Rezende Barbosa Marianne P C, Daminello-Raimundo Rodrigo, de Lucca Augusto A, de Abreu Luiz C
Design of Studies and Scientific Writing Laboratory in the ABC Medicine Faculty, Santo André, São Paulo, Brazil.
Coronary Center of the Messejana Hospital Dr. Carlos Alberto Studart Gomes, Fortaleza, Ceará, Brazil.
Ann Noninvasive Electrocardiol. 2018 Jul;23(4):e12512. doi: 10.1111/anec.12512. Epub 2017 Oct 19.
Catecholaminergic polymorphic ventricular tachycardia is a rare devastating lethal inherited disorder or sporadic cardiac ion channelopathy characterized by unexplained syncopal episodes, and/or sudden cardiac death (SCD), aborted SCD (ASCD), or sudden cardiac arrest (SCA) observed in children, adolescents, and young adults without structural heart disease, consequence of adrenergically mediated arrhythmias: exercise-induced, by acute emotional stress, atrial pacing, or β-stimulant infusion, even when the electrocardiogram is normal. The entity is difficult to diagnose in the emergency department, given the range of presentations; thus, a familiarity with and high index of suspicion for this pathology are crucial. Furthermore, recognition of the characteristic findings and knowledge of the management of symptomatic patients are necessary, given the risk of arrhythmia recurrence and SCA. In this review, we will discuss the concept, epidemiology, genetic background, genetic subtypes, clinical presentation, electrocardiographic features, diagnosis criteria, differential diagnosis, and management.
儿茶酚胺能多形性室性心动过速是一种罕见的、具有毁灭性的致死性遗传性疾病或散发性心脏离子通道病,其特征为在无结构性心脏病的儿童、青少年和年轻成年人中出现无法解释的晕厥发作,和/或心源性猝死(SCD)、中止的心源性猝死(ASCD)或心脏骤停(SCA),这些是由肾上腺素介导的心律失常所致:运动诱发、急性情绪应激、心房起搏或β-激动剂输注诱发,即使心电图正常。鉴于其表现形式多样,该疾病在急诊科很难诊断;因此,熟悉并高度怀疑这种病症至关重要。此外,鉴于心律失常复发和心脏骤停的风险,识别特征性表现并了解有症状患者的管理方法是必要的。在本综述中,我们将讨论其概念、流行病学、遗传背景、遗传亚型、临床表现、心电图特征、诊断标准、鉴别诊断和管理。