Familial ST-depression syndrome represents a novel inherited disease characterized by nonischemic ST-segment depressions in multiple leads. The ECG phenotype appears to debut around puberty, while the typical onset of arrhythmias occurs around 50 years of age. Clinical manifestations include supraventricular arrhythmias, fast polymorphic ventricular tachycardia, sudden cardiac death, and left ventricular systolic dysfunction. The optimal treatment is unknown but asymptomatic individuals without red flags may not need treatment. In contrast, ICD implantation should be considered in patients with probable arrhythmic syncope and in those fulfilling general criteria for ICD treatment. Future research should focus on establishing the disease prevalence, optimizing risk stratification and treatment, and elucidating the underlying genetic etiology.
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Article Synopsis
- - A 58-year-old man with a history of intermittent chest pain and palpitations presented to a cardiology clinic; he previously had a cardiac mass found via echocardiography 3 years ago but missed follow-up care.
- - His medical history showed no other significant issues, but he has a family history of sudden cardiac death due to his father's heart attack at age 57.
- - Physical and lab examinations were mostly normal, but ECG indicated sinus rhythm with ST depression, and further imaging tests (cardiac CT and MRI) were scheduled to assess the irregular left ventricle mass.
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