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Unusual echocardiogram in a 38-year-old man with loss of consciousness and systolic murmur
  1. Barbara Chybowska,
  2. Magdalena Lipczyńska,
  3. Anna Wójcik,
  4. Anna Klisiewicz,
  5. Piotr Hoffman
  1. Department of Adult Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland
  1. Correspondence to Dr Barbara Chybowska, Klinika Wad Wrodzonych Serca, Instytut Kardiologii, ul. Alpejska 42, Warszawa 04-628, Poland; bchybowska{at}

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A 38-year-old man presented with two episodes of transient loss of consciousness accompanied by intermittent palpitations and some episodes of dizziness over the last several months. Loss of consciousness was associated with the loss of postural tone followed once by a fall with a head injury. He had no prior cardiac history but was diagnosed with lymphoblastic lymphoma at the age of 7 years. He had been treated with irradiation to the left supraclavicular region and subsequent chemotherapy. Physical examination revealed 3/6 crescendo-decrescendo systolic murmur best heard at the second intercostal space in the right upper sternal border and radiating to the carotid arteries. There was also other 2/6 holosystolic murmur loudest over the apex with radiation to the left axilla. An ECG demonstrated normal sinus rhythm …

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  • Contributors All the authors gave their final approval of the version published. Additionally, BC was involved in the concept of the manuscript, data collection, analysis and interpretation and drafting the article; ML was involved in image acquisition, in the concept and critical revision of the manuscript; AW was involved in the concept of the manuscript, data analysis and interpretation; AK and PH were involved in the concept and revision of the article for important intellectual content.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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