Exercise-Induced Ventricular Arrhythmia: Initial Presentation of Occult Barlow Syndrome Unmasked by Stress Testing.

Authors

Yujun Sun

Published in

JACC. Case reports. Pages 110384. Sep 23, 2026. Epub Sep 23, 2026.

Abstract

Barlow syndrome, a form of myxomatous mitral valve prolapse, often presents with nonspecific symptoms and may be missed on resting examination.
A 38-year-old woman presented with recurrent palpitations triggered by stress and poor sleep. Resting physical examination was unremarkable. Exercise stress test (EST) revealed frequent premature ventricular contractions and a midlate systolic apical click postexercise, which were both previously absent at rest. Echocardiography confirmed Barlow syndrome with 7 mm mitral annular disjunction (MAD). Beta-blocker therapy was initiated with symptomatic improvement.
The EST unmasked both electrophysiological and auscultatory abnormalities entirely occult on standard resting evaluation. This case offers a practical diagnostic reference for recognizing latent cardiac diseases in patients with nonspecific symptoms.
EST plays a crucial role in diagnosing atypical Barlow syndrome by unmasking both arrhythmias and characteristic auscultatory findings. Beta-blocker therapy effectively improves symptoms in patients with mitral annular disjunction-associated exercise-induced arrhythmias.

PMID:
42886127
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

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