Page 39 - BH-1-1

Brain & Heart

CASE REPORT
An unconventional dose of epinephrine

for a diagnostic test of catecholaminergic
polymorphic ventricular tachycardia: A case

report

Xianghui Chen, Yongji Lai, and Jun Guo*
Department of Cardiology, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China

Abstract
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare heritable
arrhythmogenic disease, and the Mayo Clinic protocol-guided epinephrine test
is commonly used for diagnostic purposes. Whether the Mayo Clinic protocol is
enough for patients who are insensitive to catecholamine remains an unknown
question. Our patient was a19-year-old female who presented with recurrent stress-
induced syncope and was saved by cardiopulmonary resuscitation. The initial
physical examination and complementary tests (ECG, blood laboratory, cardiac
ultrasound, and cranial magnetic resonance angiography) showed no abnormalities
on admission. Treadmill exercise testing shows non-sustained and polymorphic
tachycardia. A subsequent epinephrine test was performed, and polymorphic
ventricular tachycardia was not induced until using a high dose of epinephrine
above Mayo Clinic protocol. Therefore, it is suggested that an unconventional dose
*Corresponding author: of epinephrine may be needed fordiagnostic tests of CPVT for some insensitive
Jun Guo
(dr.guojun@163.com) individuals.
Citation: Chen X, Lai Y, Guo J,
2023, An unconventional dose of Keywords: Catecholaminergic polymorphic ventricular tachycardia; Syncope;
epinephrine for a diagnostic test
of catecholaminergic polymorphic Epinephrine test
ventricular tachycardia: A case
report. Brain & Heart, 1(1): 0325.
https://doi.org/10.36922/bh.0325
Received: March 12, 2023 1. Background
Accepted: April 27, 2023 Syncope is a transient loss of consciousness, and its differential diagnosis is sometimes
Published Online: May 23, 2023 difficult. Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare
heritable arrhythmogenic disease characterized by adrenergic-induced bidirectional
Copyright: © 2023 Author(s). [1]
This is an Open Access article or polymorphic VT . The prevalence of CPVT is estimated at 1:10,000; however, the
distributed under the terms of the mortality rate is as high as 30% by the age of 30 if untreated. Therefore, early diagnosis
Creative Commons Attribution of CPVT is of great importance, and epinephrine plays an important role in the standard
License, permitting distribution, [2]
and reproduction in any medium, diagnostic test . Here, we present a special case of CPVT during our diagnostic test
provided the original work is using an unconventional dose of epinephrine.
properly cited.
Publisher’s Note: AccScience 2. Case presentation
Publishing remains neutral with A 19-year-old female who had repetitive episodes of syncope induced by physical exertion
regard to jurisdictional claims in
published maps and institutional was referred to our hospital. About 1 year earlier, she suddenly lost consciousness at
affiliations. school during exercise. Paramedics found her pulseless and started cardiopulmonary

Volume 1 Issue 1 (2023) 1 https://doi.org/10.36922/bh.0325