NON-SUSTAINED VENTRICULAR TACHYCARDIA (VT) IN A YOUNG WOMAN WITHOUTSTRUCTURAL HEART DISEASE
Background: Ventricular arrhythmias usually occur in the setting of significant structural heart disease but there are also cases of ventricular tachycardia (VT) in which the arrhythmia occurs in the absence of identifiable structural heart disease.
Methods: A 42-years-old female presented to the hospital complaining of palpitations of variable duration that led in one instance to presyncope.
Results: The ECG performed in the emergency setting was normal. No riskfactors was identified except smoking and occasional exposure to psychic stress. The physical examination and echocardiography revealed no clinical significant findings. Stress test revealed asymptomatic isolated ventricular premature beats. 24-hours Holter monitoring identified one nonsustained episode of ventricular tachycardia with duration of 5 seconds. The patient recorded palpitations at the time of the episodes. Beta-blocker therapy was initiated and newrepeated24-hours Holter was negative after two weeks of treatment.
Discussion and conclusion: Palpitations are one of the most common problems of outpatients presenting to cardiologists. Although usually benign, they are occasionally a manifestation of potentially life-threatening conditions. There is a regrettable tendency to ascribe palpitations to anxiety, particularly when they occur in young women.
One important determinant of prognosis is the presence or absence of underlying heart disease.
Although there is good evidence that psychiatric disorders are a common cause of palpitations in apparent healthy individuals, this diagnosis should not be accepted until true arrhythmic causes have been excluded. The findings also should encourage physicians who care for patients with palpitation to perform routine Holter monitoring.