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Abnormal ECG findings in a young patient with presyncope
  1. Karl-Philipp Rommel1,
  2. Christian Paech2,
  3. Matthias Grothoff3,
  4. Gerd Hindricks1,
  5. Ole-Alexander Breithardt1
  1. 1Department of Cardiology and Rhythmology, Heart Center, University Hospital, Leipzig, Germany
  2. 2Department for Pediatric Cardiology, Heart Center, University Hospital, Leipzig, Germany
  3. 3Department for Diagnostic and Interventional Radiology, Heart Center, University Hospital, Leipzig, Germany
  1. Correspondence to Dr Karl-Philipp Rommel, Herzzentrum Leipzig, Universitätsklinik, Abteilung für Kardiologie, Strümpellstr. 39, Leipzig DE-04289, Germany; Karl_Ph_Rommel{at}web.de

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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.

Figure 1

12-Lead ECG at rest.

Figure 2

Transthoracic echocardiogram from typical apical 4-chamber view position during shallow breathing.

Figure 3

12-Lead ECG at rest on deep inspiration.

Figure 4

Transthoracic echocardiogram from typical apical 4-chamber view position during deep inspiration.

Cardiac MRI …

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