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A 48-year-old man presented with cardiorespiratory arrest while swimming. An automated external defibrillator was attached displaying a non-shockable rhythm. Cardiopulmonary resuscitation was commenced by the lifeguard with return of circulation and ventilation.
He had previously been investigated for atypical chest pain, including with an exercise treadmill test that was stopped due to marked hypertensive response.
Initial examination revealed bilateral crepitations throughout the lung fields and a loud systolic murmur, heard throughout the precordium, but loudest at the left sternal edge. ECG was unremarkable. Manually assessed QTc was 420 ms.
Troponin T …