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A 19-year-old male patient was referred to our institution for further evaluation after a first episode of palpitations with presyncope. His past medical history and family history were unremarkable. A resting ECG and a transthoracic echocardiography from a typical apical 4-chamber view position were recorded during shallow breathing (figures 1 and 2, see online supplementary movies 1 and 2) and on deep inspiration (figures 3 and 4, see online supplementary movies 1 and 2). Repeated Holter monitoring did not show any relevant arrhythmia, except for marked sinus arrhythmia; premature ventricular contraction (PVC) count was less than 100/day.
Cardiac MRI …
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