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KMID : 0390620130210030148
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Journal of Cardiovascular Ultrasound
2013 Volume.21 No. 3 p.148 ~ p.151
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Recurrent Syncope Episodes and Exercise Intolerance in Hypertrophic Cardiomyopathy Combined with Atrioventricular Conduction Disturbance
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Kim Kyun-Hee
Yang Dong-Heon
Kim Chang-Yeon
Kim Nam-Kyun
Choi Won-Suk
Bae Myung-Hwan
Lee Jang-Hoon
Park Hun-Sik
Cho Yong-Keun
Chae Shung-Chull
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Abstract
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A 30-year-old female patient with known hypertrophic cardiomyopathy (HCMP) was admitted for recurrent syncope episodes. Electrocardiogram (ECG) showed 2 : 1 atrioventricular (AV) block. Stress echocardiography with bicycle showed high grade AV block at high stage of the exercise associated with exercise intolerance and dyspnea. Twenty-four hour ECG monitoring also revealed high grade AV block and 1 episode of non-sustained ventricular tachycardia. Implantable cardioverter/defibrillatorpacemaker (ICD-P) was inserted. After implantation of ICD-P, conduction disturbance and exercise intolerance were improved. AV block is a rare complication HCMP. There are just a few case reports that present symptoms caused by conduction disturbance in HCMP. This case describes repeated syncope episodes and exercise intolerance caused by conduction disturbance during exercise in HCMP patient. For evaluating the cause of syncope in HCMP, stress echocardiography can be helpful to understand the probable mechanism of syncope.
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KEYWORD
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Hypertrophic cardiomyopathy , Syncope , Atrioventricular block , Stress echocardiography
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