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Exercise-Induced Intraventricular Obstruction in a Child with Near Syncope and Chest Pain During Exercise

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Abstract

We report the case of a 10-year-old girl with two episodes of light-headedness and chest pain during exercise. She had an unremarkable clinical record, physical examination, ECG, and echocardiogram. Noninvasive ischemia tests were positive, but coronary angiography was normal. Exercise stress echocardiogram revealed an exercise-induced intra-left-ventricular obstruction with a peak gradient of 78 mmHg and replicated her symptoms. After starting beta-blocker therapy her clinical status improved and no residual obstruction was detected. The authors review this unsuspected clinical condition, seldom reported in the adult population and, to our knowledge, never before in a child.

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References

  1. Bueno CF, Bailón IR, Salguero RL, Doblas JJ, Cabeza AP, Hernández JP, Franco AD, Hidalgo LM, Galván ET (2004) Dynamic left ventricular outflow tract obstruction induced by exercise. Rev Esp Cardiol 57(12):1179–1187

    Article  Google Scholar 

  2. Bueno FC, Bailón IR, Salguero RL, Doblas JJ, Pinilla JM, Galván ET (2006) Effect of exercise on systolic left ventricular outflow velocity in healthy adults. Rev Esp Cardiol 59(2):180–182

    Article  Google Scholar 

  3. Bueno FC, Pinilla JM, Doblas JJ, Trujillo AM, Bailón IR, Galván ET (2007) Beta-blocker therapy for dynamic left ventricular outflow tract obstruction induced by exercise. Int J Cardiol 117:222–226

    Article  Google Scholar 

  4. Cotrim C, Loureiro MJ, Simões O, Cordeiro P, Henriksson I, Vinhas H, Almeida A, Carrageta M (2005) Intraventricular gradient during effort in a professional soccer player. Clinical significance. Rev Port Cardiol 24(11):1395–1401

    PubMed  Google Scholar 

  5. Cotrim C, Almeida AG, Carrageta M (2008) Exercise-induced intra-ventricular gradients as a frequent potential cause of myocardial ischemia in cardiac syndrome X patients. Cardiovasc Ultrasound 6:3

    Article  PubMed  Google Scholar 

  6. Cotrim C, Almeida AG, Carrageta M (2008) Do healthy individuals develop intra-ventricular gradients during exertion? Rev Port Cardiol 27(11):1367–1375

    PubMed  Google Scholar 

  7. Driscoll DJ, Jacobsen SJ, Porter CJ, Wollan PC (1997) Syncope in children and adolescents. J Am Coll Cardiol 29(5):1039–1045

    Article  PubMed  CAS  Google Scholar 

  8. Maron MS, Olivotto I, Betocchi S, Casey SA, Lesser JR, Losi MA, Cecchi F, Maron BJ (2003) Effect of left ventricular outflow tract obstruction on clinical outcome in hypertrophic cardiomyopathy. N Engl J Med 348:295–303

    Article  PubMed  Google Scholar 

  9. The Task Force for the Diagnosis, Management of Syncope of the European Society of Cardiology (2009) Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 30:2631–2671

    Article  Google Scholar 

  10. Yotti R (2004) Qué significado tiene un gradiente de presión intraventricular sistólico durante el ejercicio? Rev Esp Cardiol 57(12):1139–1142

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Cardiology Department, Hospital Divino Espírito Santo, Rua Grotinha, 9500-370, Ponta Delgada, Portugal

    Artur Lopes

  2. Pediatric Cardiology Department, Hospital de Santa Marta, Lisbon, Portugal

    Artur Lopes, José D. F. Martins & Fátima Pinto

  3. Cardiology Department, Hospital Garcia de Orta, Almada, Portugal

    Carlos Cotrim

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  1. Artur Lopes
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  2. Carlos Cotrim
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  3. José D. F. Martins
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  4. Fátima Pinto
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Correspondence to Artur Lopes.

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Lopes, A., Cotrim, C., Martins, J.D.F. et al. Exercise-Induced Intraventricular Obstruction in a Child with Near Syncope and Chest Pain During Exercise. Pediatr Cardiol 32, 1032–1035 (2011). https://doi.org/10.1007/s00246-011-0052-3

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  • DOI: https://doi.org/10.1007/s00246-011-0052-3

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