Recurrent syncope in a 62-year-old man

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Figure 1
Polymorphic ventricular tachycardia episodes captured on continuous telemetry.

TABLE 1

Initial laboratory test results

Test	Result (reference range)^{^a}
Comprehensive metabolic panel
Protein, total	8.2 g/dL (6.3–8.0)
Albumin	3.9 g/dL (3.9–4.9)
Calcium, total	10.1 mg/dL (8.5–10.2)
Bilirubin, total	0.4 mg/dL (0.2–1.3)
Alkaline phosphatase	72 U/L (38–113)
Aspartate aminotransferase	39 U/L (14–40)
Alanine transaminase	26 U/L (10–54)
Glucose	117 mg/dL (74–99)
Blood urea nitrogen	19 mg/dL (9–24)
Serum creatinine	1.47 mg/dL (0.73–1.22)
Sodium	135 mmol/L (136–144)
Potassium	4.0 mmol/L (3.7–5.1)
Chloride	102 mmol/L (97–102)
Carbon dioxide	23 mmol/L (22–30)
Anion gap	10 mmol/L (9–18)
Estimated glomerular filtration rate	54 mL/minute/1.73 m² (≥ 60)
Complete blood cell count
White blood cell count	5.47 x 10⁹/L (3.70–11.00)
Red blood cell count	3.46 x 10⁹/L (4.20–6.00)
Hemoglobin	10.2 g/dL (13–17)
Hematocrit	32.4% (39–51)
Mean corpuscular volume	93.6 fL (80.0–100.0)
Mean corpuscular hemoglobin	29.5 pg (26.0–34.0)
Mean corpuscular hemoglobin concentration	31.5 g/dL (30.5–36.0)
Red cell distribution width-coefficient of variation	14.5% (11.5–15.0)
Platelet count	250 x 10⁹/L (150–400)
Mean platelet volume	9.5 fL (9.0–12.7)
Urine dipstick
Protein	2+ (negative)
Blood	1+ (negative)
Miscellaneous
Magnesium	2.3 mg/dL (1.7–2.3)
Ionized calcium	1.31 mmol/L (1.08–1.30)
High-sensitivity troponin T	56 ng/L (< 12)
N-terminal pro-brain natriuretic peptide	2,397 pg/mL (< 125)
D-dimer	1,060 ng/mL (< 500)