Exercise-related QT interval shortening with a peaked T wave in a boy with MEN 2 syndrome

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• 作者：Mutlu Gungor ; MD^a ; Ozcan Ozeke ; MD^b ; ^{ozcanozeke@gmail.com} ; Sabri Sayinalp ; MD^c ; Cagatay Ertan ; MD^b ; Ahmet Duran Demir ; MD^b ; Gurler Ilicin ; MD^a ; Can Ozer ; MD^a
• 关键词：Exercise-induced arrhythmia ; MEN syndrome
• 刊名：Journal of Cardiology Cases
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：7
• 期：4
• 页码：e93-e96
• 全文大小：2213 K

文摘

Multiple endocrine neoplasia 2 (MEN 2) is a hereditary syndrome associated with medullary thyroid carcinoma, pheochromocytoma (PCC), and hyperparathyroidism. PCCs in patients with MEN 2 are usually found in the adrenals after the manifestation of medullary thyroid cancer and are commonly bilateral and hormonally active. Unfortunately, a diagnosis of MEN 2 or PCC often is delayed until after the patient has developed an advanced MEN 2-related tumor. We present unusual electrocardiographic changes on exercise testing in MEN 2 syndrome. Transient peaked T waves and shortening QT during exercise stress testing may provide an early clue for undiagnosed PCC.

<Learning objective: Stress testing is not just for the diagnosis of ischemia but it may be used to evaluate patients with symptoms that suggest exercise-induced arrhythmias. The pheochromacytoma is a disorder characterized by excess of catecholamines and is usually difficult to diagnose. Excessive sympathetic stimulation is toxic to myocytes and this toxicity may reveal itself as ECG changes such as peaked T waves and shortening of QT interval. Such changes on ECG during sympathetic stimulation such as exercise testing should raise the suspicion of pheochromacytoma.>