Paroxysmal Ventricular Tachycardia in the Absence of Organic Heart Disease
Authors: MICHAEL LESCH
Journal: Annals of Internal Medicine (1967)

Case Studies1 May 1967Paroxysmal Ventricular Tachycardia in the Absence of Organic Heart DiseaseReport of a Case and Review of the LiteratureMICHAEL LESCH, M.D., EDMUND LEWIS, M.D., J. O'NEAL HUMPHRIES, M.D., RICHARD S. ROSS, M.D., F.A.C.P.MICHAEL LESCH, M.D., EDMUND LEWIS, M.D., J. O'NEAL HUMPHRIES, M.D., RICHARD S. ROSS, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-950 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThis report concerns a healthy-looking young mother of five who had no organic heart disease but was disabled by paroxysms of ventricular tachycardia. In this setting the arrhythmia is usually benign, but the rare occurrence of death in such a patient dictates that an effective therapeutic program be established and vigorously pursued. Management depends upon knowledge of the clinical spectrum of the disease, which has not been reviewed although many single cases have been reported. This report provides such a summary of available information and reports an additional case.CASE REPORTPatient A. M., a 25-year-old white woman, was admitted...References1. FROMENTGALLAVARDINCAHEN RLP: Paroxysmal ventricular tachycardia. A clinical classification. Brit. Heart J. 15: 172, 1953. CrossrefMedlineGoogle Scholar2. LIDMANLYERLY BIJM: Paroxysmal ventricular tachycardia occurring in the absence of demonstrable heart disease. Ann. Intern. Med. 24: 118, 1946. LinkGoogle Scholar3. ELLIOTTFENN ARGK: Long continued ventricular tachycardia. Report of an unusual case. Amer. Heart J. 9: 806, 1923. CrossrefGoogle Scholar4. RINGBLANKFEIN AJ: Paroxysmal ventricular tachycardia in an apparently normal heart. Ann. Intern. Med. 42: 680, 1955. LinkGoogle Scholar5. SMITH LB: Paroxysmal ventricular tachycardia followed by an electrocardiographic syndrome. Amer. Heart J. 32: 257, 1946. CrossrefMedlineGoogle Scholar6. STEINDRISCOL MHRE: Paroxysmal ventricular tachycardia with acute left ventricular failure in a patient with no evidence of organic heart disease. Ann. Intern. Med. 26: 769, 1947. LinkGoogle Scholar7. WOLFERTHMCMILLAN CCTM Paroxysmal ventricular tachycardia: report of one case with normal type of auricular mechanism and three with auricular fibrillation. Arch. Intern. Med. (Chicago) 31: 184, 1923. CrossrefGoogle Scholar8. WILSONWISHARTMACLEODBAKER FNSWAGPS: A clinical type of paroxysmal tachycardia of ventricular origin in which paroxysms are induced by exertion. Amer. Heart J. 8: 155, 1932. CrossrefGoogle Scholar9. GILCHIST AR: Paroxysmal ventricular tachycardia. Amer. Heart J. 1: 546, 1926. CrossrefGoogle Scholar10. MARVINWHITE HMPD: Observation on paroxysms of tachycardia. Arch. Intern. Med. (Chicago) 29: 403, 1922. CrossrefGoogle Scholar11. RALLYWALTERS CRMB: Paroxysmal ventricular tachycardia without evident heart disease. Canad. Med. Ass. J. 86: 268, 1962. MedlineGoogle Scholar12. MCMILLANBELLET TMS: Ventricular paroxysmal tachycardia: report of a case in a pregnant girl of 16 years with an apparently normal heart. Amer. Heart J. 7: 70, 1931. CrossrefGoogle Scholar13. FREUNDLICH J: Paroxysmal ventricular tachycardia. Amer. Heart J. 31: 557, 1946. CrossrefMedlineGoogle Scholar14. MARRA AF: Report of a case of paroxysmal ventricular tachycardia with no demonstrable organic heart disease which produced attacks of syncope. Amer. Heart J. 28: 810, 1944. CrossrefGoogle Scholar15. ADAMS CW: Functional paroxysmal ventricular tachycardia. Amer. J. Cardiol. 9: 215, 1962. CrossrefMedlineGoogle Scholar16. HAIREAGANORGAIN TEJTES: Paroxysmal ventricular tachycardia in the absence of demonstrable heart disease. Ibid., p. 209. Google Scholar17. VAKIL RJ: Repetitive paroxysmal ventricular tachycardia with fusion beats. Brit. Heart J. 19: 293, 1957. CrossrefMedlineGoogle Scholar18. BJERKELUND CJ: Benign paroxysmal ventricular tachycardia in a 10 year old boy. Acta Med. Scand. 133: 139, 1949. CrossrefMedlineGoogle Scholar19. PETERSPENNER MSL: Orthostatic paroxysmal ventricular tachycardia. Amer. Heart J. 32: 645, 1946. CrossrefMedlineGoogle Scholar20. MADDOX K: Intermittant ventricular tachycardia in a youth, report of a case with fatal termination. Amer. Heart J. 33: 739, 1947. Google Scholar21. ANDERSON MC: Paroxysmal ventricular tachycardia. Amer. J. Med. Sci. 181: 369, 1931. CrossrefGoogle Scholar22. ROSENBAUMJOHNSTONKELLER FFFDAP: Paroxysmal ventricular tachycardia in childhood. Amer. J. Dis. Child. 64: 1030, 1942. Google Scholar23. FRIEDMANASHKLEIN SRD: Repetitive paroxysmal ventricular tachycardia: report of a case in a child. Pediatrics 22: 738, 1958. MedlineGoogle Scholar24. AMBRUSTLEVINE CS: Paroxysmal ventricular tachycardia. A study of 107 cases. Circulation 1: 28, 1950. CrossrefMedlineGoogle Scholar25. HERMANNHEJTMANCIK GRM: A clinical and electrocardiographic study of paroxysmal ventricular tachycardia and its management. Ann. Intern. Med. 28: 989, 1948. LinkGoogle Scholar26. WILLIAMSELLIS CLB: Ventricular tachycardia: analysis of 36 cases. Arch. Intern. Med. (Chicago) 71: 137, 1943. CrossrefGoogle Scholar27. COOKEWHITE WTPD: Paroxysmal ventricular tachycardia. Brit. Heart J. 5: 33, 1943. CrossrefMedlineGoogle Scholar28. STRAUSS MB: Paroxysmal ventricular tachycardia. Amer. J. Med. Sci. 179: 337, 1930. CrossrefGoogle Scholar29. MACKENZIEPASCUAL GJS: Paroxysmal ventricular tachycardia. Brit. Heart J. 26: 441, 1964. CrossrefMedlineGoogle Scholar30. CAMPBELLELLIOT MGG: Paroxysmal tachycardia: aetiology and prognosis of 100 cases. Brit. Heart J. 1: 23, 1939. CrossrefGoogle Scholar31. BARCROFTBOCKROUGHTON JAVFJ: Observations on the circulation and respiration in a case of paroxysmal tachycardia. Heart 9: 7, 1921-22. Google Scholar32. WILLIUS FA: Paroxysmal tachycardia of ventricular origin. Boston Med. Surg. J. 178: 40, 1918. CrossrefGoogle Scholar33. HARVEYLEVINE WPSA: Paroxysmal ventricular tachycardia due to emotion. JAMA 150: 479, 1952. CrossrefMedlineGoogle Scholar34. SCOTT RW: Observations on a case of ventricular tachycardia with retrograde conduction. Heart 9: 297, 1921-22. Google Scholar35. JICKSMITH HJE: An unusual case of bigeminy due to vagal tone. Amer. J. Cardiol. 12: 741, 1963. CrossrefMedlineGoogle Scholar36. SCHERFCOHENRAFAILZADEH DJM: Excitatory effect of carotid sinus pressure. Enhancement of ectopic impulse formation and of impulse conduction. Amer. J. Cardiol. 17: 240, 1966. CrossrefMedlineGoogle Scholar37. LANGENDORFPICKWINTERNITZ RAM: Mechanisms of intermittent ventricular bigeminy. I. Appearance of ectopic beats dependent upon length of the ventricular cycle, the rule of bigeminy. Circulation 11: 422, 1955. CrossrefMedlineGoogle Scholar38. HEIMANHELWIG DFJ: Suppression of ventricular arrhythmias by transvenous intracardiac pacing. JAMA 195: 1150, 1966. CrossrefGoogle Scholar39. SOWTONLEATHAMCARSON EAP: The suppression of arrhythmias by artificial pacing. Lancet 2: 1098, 1964. CrossrefMedlineGoogle Scholar40. ZOLLLINENTHAL PMAJ: External and internal cardiac pacemakers. Circulation 28: 455, 1963. CrossrefMedlineGoogle Scholar41. HOFFMANCRANEFIELD BFPF: The Electro-physiology of the Heart. McGraw-Hill Book Co., New York, 1960. Google Scholar42. JONESWHITE TDPD: Paroxysmal ventricular tachycardia: report of an unusual case. Amer. Heart J. 2: 139, 1926. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Baltimore, MarylandFrom The Department of Medicine, Johns Hopkins University School of Medicine and Johns Hopkins Hospital, Baltimore, Md.This research was supported in part by grants 2 RO1 HE 05584, the National Heart Institute, and by grant FR-35, the Clinical Center, The Division of General Medical Sciences, the National Institutes of Health, Bethesda, Md.Dr. Humphries was supported in part by graduate training grant 2 T1 HE 5159 and undergraduate training grant 5 T2 HE 260, the National Heart Institute. Dr. Ross was supported by career development award 5-K-3695, the National Heart Institute.Requests for reprints should be addressed to J. O'Neal Humphries, M.D., Johns Hopkins Hospital, 601 N. Broadway, Baltimore, Md. 21205. 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