Left ventricular outflow tract obstruction caused unexplained syncope in 4 athletes with or without significant hypertrophy, demonstrating the diagnostic utility of stress echocardiography.
Can stress transthoracic echocardiography identify left ventricular outflow tract obstruction as a cause of unexplained syncope in athletes?
Stress transthoracic echocardiography is useful for detecting LVOTO as a cause of unexplained syncope in athletes, which can drastically change clinical management such as avoiding unnecessary ICD placement.
Absolute Event Rate: 0% vs 0%
Evaluation of syncope in athletes can be challenging, with a vast array of potential explanations ranging from vasovagal to ventricular arrhythmias secondary to an arrhythmogenic cardiomyopathy. The evaluation of syncope requires a thorough history and physical examination, electrocardiogram, and in many cases further diagnostic testing and imaging including stress testing, transthoracic echocardiography, and cardiac magnetic resonance imaging. In this case series, we report 4 cases of previously unexplained syncope in athletes of various levels, with the underlying mechanism of left ventricular outflow tract obstruction (LVOTO). Our findings indicate that LVOTO can cause syncope with or without the presence of significant left ventricular hypertrophy. These cases demonstrate the utility of stress transthoracic echocardiography in eliciting LVOTO and how detecting LVOTO can drastically change clinical management for athletes, especially with respect to implantable cardioverter-defibrillator placement.
Bavishi et al. (Sun,) reported a other. Left ventricular outflow tract obstruction caused unexplained syncope in 4 athletes with or without significant hypertrophy, demonstrating the diagnostic utility of stress echocardiography.