A 22-year-old male patient presented to the emergency department of our institution with recurrent syncope.
Being at rest at home, one hour after the completion of boxing training, she presented sudden consciousness compromise of approximately one minute duration, with subsequent complete recovery.
In the next two hours he repeated syncope episodes of similar characteristics on three occasions.
In the hospital access hall, the patient presented a new syncope episode, so the emergency box was immediately evaluated.
On admission, blood pressure was 126/82 mmHg, heart rate 82 bpm, saturation 99% and axillary temperature 36°C. The patient reported no significant comorbidities or family history of heart disease.
During the initial ECG patient repeated syncope, objectifying in the ventricular fibrillation tracing.
Resuscitation maneuvers were initiated and the patient became sinus rhythm after a few seconds.
An ECG was repeated, which showed an image of incomplete right bundle branch block, ST elevation and T wave inversion in right precordial leads, suggesting a type 1 Bragada pattern.
A few minutes later, a new episode of ventricular fibrillation was observed, and the immediate placement was performed with 200 Joules of biphasic current, emitting sinus rhythm.
The patient was hospitalized in the Coronary Unit, where he was sedated with lorazepam and it was decided to start infusion of isoproterenol at a dose of 0.25 ug/min.The normalization pattern of the internal ST segment was observed.
The patient was admitted favorably with an antiarray infusion on the second day and implanted cardiodesflatant bicam (Protecta CRT-D, Medtronic) without incidents.
She was discharged in good condition on the third day of hospitalization without antiarray medication.
At one month follow-up, no arrhythmic events were recorded when the device was checked.
