AccScience Publishing / BH / Volume 1 / Issue 1 / DOI: 10.36922/bh.0325
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CASE REPORT

An unconventional dose of epinephrine for a diagnostic test of catecholaminergic polymorphic ventricular tachycardia: A case report

Xianghui Chen1 Yongji Lai1 Jun Guo1*
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1 Department of Cardiology, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
Brain & Heart 2023, 1(1), 0325 https://doi.org/10.36922/bh.0325
Submitted: 12 March 2023 | Accepted: 27 April 2023 | Published: 23 May 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare heritable arrhythmogenic disease, and the Mayo Clinic protocol-guided epinephrine test is commonly used for diagnostic purposes. Whether the Mayo Clinic protocol is enough for patients who are insensitive to catecholamine remains an unknown question. Our patient was a19-year-old female who presented with recurrent stress-induced syncope and was saved by cardiopulmonary resuscitation. The initial physical examination and complementary tests (ECG, blood laboratory, cardiac ultrasound, and cranial magnetic resonance angiography) showed no abnormalities on admission. Treadmill exercise testing shows non-sustained and polymorphic tachycardia. A subsequent epinephrine test was performed, and polymorphic ventricular tachycardia was not induced until using a high dose of epinephrine above Mayo Clinic protocol. Therefore, it is suggested that an unconventional dose of epinephrine may be needed fordiagnostic tests of CPVT for some insensitive individuals.

Keywords
Catecholaminergic polymorphic ventricular tachycardia
Syncope
Epinephrine test
Funding
Guangzhou Committee of Science and Technology, China
Clinical frontier new technology of the First Affiliated Hospital of Jinan University
Conflict of interest
The authors declare no conflicts of interest.
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Brain & Heart, Electronic ISSN: 2972-4139 Published by AccScience Publishing