Recurrent Symptomatic Supraventricular Tachycardia In A Collegiate Volleyball Player

Abstract

ACSM Case Report SubmissionCalan Sowa, MD HISTORY: A 21-year-old collegiate women’s volleyball player with a past medical history of supraventricular tachycardia (SVT) ablated in July of 2020 presented to the training room after developing shortness of breath and palpitations while participating in volleyball practice. Her symptoms arose spontaneously, and she experienced no chest pain or dizziness, endorsed no recent fevers or chills and had no recent sick contacts. She had no history of illicit substance use and had been otherwise feeling well. PHYSICAL EXAMINATION: Examination in the training room revealed regular tachycardia at a rate of approximately 200 beats per minute. Blood pressure was within normal limits. The patient exhibited no dyspnea and bilateral lungs were clear to auscultation. Neurologic exam was within normal limits. EKG was not available in the training room and therefore the patient was instructed to report to the Emergency Room for further evaluation. DIFFERENTIAL DIAGNOSIS: 1. Supraventricular tachycardia2. Ventricular tachycardia3. Viral myocarditis TESTS AND RESULTS: Troponin I: normalBasic Metabolic Panel: normalEKG: Normal sinus rhythm with HR 56 bpm48-Hour Holter Monitor: -Predominant rhythm: SVT with normal AV conduction-Average HR: 75 bpm, Minimum HR 44 bpm, Maximum HR 194 bpm-Ectopy: Occasional PACs without ventricular ectopy-Dysrhythmias: Supraventricular tachycardia (SVT); 399 beats at 215 bpm-Symptoms: Palpitations and shortness of breath reported once at which time the rhythm was sinus with a rate of 53 bpm FINAL WORKING DIAGNOSIS: Recurrent SVT TREATMENT AND OUTCOMES: 48-hour Holter monitoring confirmed an episode of recurrent SVT lasting for approximately twenty seconds that occurred during participation in volleyball practice. The patient was referred to cardiology and ultimately elected to follow up with her home cardiologist in Virginia. She is awaiting evaluation and resulting medical/procedural management and return-to-play instruction.