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A 42-year-old woman collapses in a park
  1. Meghan K Borden Trojan1,
  2. Sandeep M Patel2,
  3. Stephen C Cook3
  1. 1Division of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  2. 2Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  3. 3Division of Adult Congenital Heart Disease, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Meghan K Borden Trojan, Division of Internal Medicine, University of Pittsburgh Medical Center, 5230 Centre Ave, Room 209, North Tower, Pittsburgh, PA 15232, USA; Bordenmk{at}upmc.edu

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Clinical introduction

A 42-year-old women with a history of mitral regurgitation was playing tennis when she suddenly collapsed. Bystanders performed cardiopulmonary resuscitation. An automated external defibrillator revealed polymorphic ventricular tachycardia. The patient was shocked once with 200 J with return of spontaneous circulation. She was brought to the emergency department where her vitals revealed a heart rate of 133 beats/min, a respiratory rate of 30 breaths/min, an oxygen saturation of 89% and a blood pressure of 124/98 mm Hg. She was intubated. The chest X-ray revealed cardiomegaly. An ECG revealed sinus tachycardia, left axis deviation, Q waves in V1–V3, lateral T-wave inversions, …

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