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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Catecholaminergic Ventricular Tachycardia (CPVT)
Introduction
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare, but life-threatening inherited arrhythmia. It is triggered by physical activity or emotional stress and is not associated with structural heart disease.
Causes and Mechanism
CPVT is primarily caused by mutations in genes related to calcium signaling in heart muscle cells, such as RYR2 or CASQ2. These mutations result in abnormal calcium handling within cardiomyocytes, leading to ventricular tachycardia (VT) during periods of high catecholamine (adrenaline) activity.
Symptoms
- Palpitations
- Syncope (fainting), especially during exercise or emotional stress
- Sudden cardiac arrest (in severe cases)
Diagnosis
- Electrocardiogram (ECG): Typically normal at rest
- Exercise stress test: Provokes arrhythmia
- Holter monitoring: Detects episodes of VT
- Genetic testing: Identifies relevant mutations
- Echocardiogram & MRI: Rule out structural heart disease
Treatment
1. Beta-blockers (e.g., Nadolol, Propranolol)
Reduce catecholamine-induced arrhythmias
2. Calcium channel blockers (e.g., Verapamil)
May provide additional benefits
3. Flecainide
Used for more severe cases resistant to beta-blockers
4. Implantable Cardioverter-Defibrillator (ICD)
For high-risk patients with a history of cardiac arrest
5. Lifestyle Modifications
Avoid strenuous exercise and emotional stress
- Family screening due to genetic nature
Conclusion
CPVT is a serious but manageable condition with early diagnosis and appropriate treatment. Patients should follow medical advice closely and ensure regular follow-ups.
Source recommendations
1. 2022 AHA/ACC/HRS Guideline for the Management of Patients With Ventricular Arrhythmias
- https://pubmed.ncbi.nlm.nih.gov/29084733/
- https://www.sciencedirect.com/science/article/pii/S2405500X22010945
- https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000000549
- https://www.jacc.org/doi/10.1016/j.jacc.2017.10.053
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
2. 2022 ESC Guidelines for the Management of Patients with Ventricular Arrhythmias
- https://academic.oup.com/eurheartj/article/43/40/3997/6675633
- https://pubmed.ncbi.nlm.nih.gov/36017572/
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
- https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/09/02/14/23/2022-ESC-Guidelines-for-VAs-ESC-2022
- https://www.sciencedirect.com/science/article/pii/S2405500X22010945
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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