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KMID : 0385920210320050467
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Journal of the Korean Society of Emergency Medicine
2021 Volume.32 No. 5 p.467 ~ p.470
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Exercise-induced polymorphic ventricular tachycardia by the R-on-T phenomenon in a patient with stable angina pectoris
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Beom Jong-Wook
Ko Yee-Kyoung
Boo Ki-Yung
Lee Jae-Geun
Choi Joon-Hyouk
Kim Song-Yi
Joo Seung-Jae
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Abstract
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Polymorphic ventricular tachycardia (PVT) is a fatal arrhythmia that can occur during the treadmill test. This report documents an instance of PVT by the R-on-T phenomenon during an exercise stress test in a 61-year-old male with stable angina pectoris. The subject performed the treadmill test for 581 seconds, and stopped after reaching 115% of the target heart rate. Ischemic ST changes were observed in leads II, III, aVF, and V3-V6 from stage 3. Premature ventricular complexes were noted during the recovery period, with an occurrence of pulseless PVT, reflective of the R-on-T phenomenon.
Spontaneous circulation was resumed after unsynchronized cardioversion at 200 J and 2 minutes of cardiopulmonary resuscitation. Emergency coronary angiography revealed 95% stenosis of the proximal right coronary artery, which was fully dilated after percutaneous coronary intervention with a drug-eluting stent. The patient was discharged without any neurologic sequelae.
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KEYWORD
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Angina, stable, Treadmill test, Premature ventricular complexes, Ventricular tachycardia
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