Galatius-Jensen S, Clemmensen P M, Pietersen A H, Nielsen H V
Hillerød Sygehus, Medicinsk afdeling B.
Ugeskr Laeger. 1994 Jan 31;156(5):657-8.
A 49-year-old woman was admitted because of several syncopes during sports activity. She was appeared well, and the physical examination revealed no pathological findings, particularly no heart murmurs. The electrocardiogram had a normal PQ, QRS and the corrected QT (QTc)interval was 0.44 s. During the exercise test no arrhythmias were seen and the QTc was unchanged of 0.44 s, but 0.6 mg atropine injected intravenously provoked prolonged QTc = 0.49 s followed by nonsustained ventricular tachycardia. Electrophysiological examination and coronary arteriography showed no inducible arrhythmias and no presence of coronary artery disease. Beta-blocker treatment was started. During one year of observation she presented no syncope, and was still active in sports. It is concluded that patients presenting with syncope and an ECG with borderline QT prolongation should undergo several provocation trials, if simple stress test is initially negative, because undiagnosed patients without prophylactic treatment have a high mortality.
一名49岁女性因运动时多次晕厥入院。她看起来状况良好，体格检查未发现病理体征，尤其没有心脏杂音。心电图PQ、QRS正常，校正QT（QTc）间期为0.44秒。运动试验期间未发现心律失常，QTc维持在0.44秒不变，但静脉注射0.6毫克阿托品后QTc延长至0.49秒，随后出现非持续性室性心动过速。电生理检查和冠状动脉造影未发现可诱发的心律失常，也未发现冠状动脉疾病。开始使用β受体阻滞剂治疗。在一年的观察期内，她未再出现晕厥，仍能积极参加运动。结论是，对于出现晕厥且心电图QT间期临界延长的患者，如果初始简单应激试验为阴性，应进行多次激发试验，因为未经诊断且未接受预防性治疗的患者死亡率很高。
