High risk syncope in a young patient: An uncommon cause

Syncope is a frequent consult. It's responsible for 1 to 3% of consults to the emergency room in the United States. The cause is generally benign; however, high-risk cases are potentially deadly and must be identified. We present a case report of a 40-year-old female who presents with syncope, Torsade de Pointes, and ventricular fibrillation. The coronary angiography showed no disease of the coronary arteries. The ventriculography, transthoracic echocardiogram, and cardiac magnetic resonance revealed a mid-ventricular Takotsubo cardiomyopathy. The ECG showed a prolonged QT interval with an inverted T wave. During the first 48 hours, she presented multiple episodes of non-sustained polymorphic ventricular tachycardia. The patient evolved with diminished QTc interval and regression of the wall motion abnormalities. At the 6-month follow-up the patient was asymptomatic, without new episodes.