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Europace 2008 10(2):235-237; doi:10.1093/europace/eun007
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

EHRA EDUCATION COMMITTEE

Case of the month by the EHRA Education committee: exercise-related arrhythmias

Isabelle C. Van Gelder1,2,*, Giuseppe Boriani3, Sabine Ernst4, Hein Heidbuchel5, Antonio Zaza6, Markku Mäkijärvi7, Bulent Gorenek Carina Blomström Lundquist on behalf of the EHRA Education Committee8,9

1 Department of Cardiology, Thoraxcenter, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands; 2 Interuniversity Cardiology Institute Netherlands, Utrecht, The Netherlands; 3 Institute of Cardiology, University of Bologna, Bologna, Italy; 4 Department of Cardiology, Royal Brompton Hospital, London, UK; 5 Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium; 6 Department di Biotecnologie e Bioscienze, University of Milano-Bicocca, Milano, Italy; 7 Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland; 8 Eskisehir Osmangazi University, Eskisehir, Turkey; 9 Department of Cardiology, University Hospital Uppsala, Uppsala, Sweden

* Corresponding author. Tel: + 31 50 3612355; fax: + 31 50 3614391. E-mail address: i.c.van.gelder{at}thorax.umcg.nl


   Abstract
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This case describes two nephews with exercise-related arrhythmias.


   Case
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Patient 1 (born in 1979) was seen at the Cardiology Department at an age of 22 years because of exercise-related palpitations accompanied by dizziness. He never had a collapse. His ECG was abnormal (Figure 1). During exercise tests, an arrhythmia occurred (Figure 2). The same arrhythmia was observed during 24 h Holter monitoring (Figure 3). His echocardiogram did not reveal any abnormality. The signal average electrocardiogram showed no late potentials.


Figure 1
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Figure 2
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His nephew was born in 1968. He was admitted at the hospital at an age of 38 years because of a serious collapse during biking. He also had an abnormal ECG (Figure 4). Echocardiography revealed an impaired right and left ventricular function. During exercise, he also developed a tachycardia (Figure 5). His signal average electrocardiogram showed late potentials, MRI showed no abnormalities except for an enlarge right and left ventricle.


Figure 4
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Figure 5
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  1. What abnormalities are present in the 12-lead electrocardiograms in Figures 1 and 4. Can these abnormalities be explained by the same disease?
  2. What test should be performed in the first patient?
  3. What arrhythmias occur during exercise in Figures 2, 3, and 5?
  4. What is the therapy?

For answers see page 256


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This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
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Right arrow Email this article to a friend
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Google Scholar
Right arrow Articles by Van Gelder, I. C.
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Right arrow Articles by Van Gelder, I. C.
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