CLINICAL INTRODUCTION A 36-year-old man was referred for evaluation of an abnormal left ventricular (LV) structure found incidentally on transthoracic echocardiography (TTE) (figure 1). He had no symptoms except for mild palpitations. There was no significant medical history. Physical examination was unremarkable. ECG showed regular sinus rhythm with ST changes in lead II, III, avF and V6 (see online supplementary file 1). Cardiac magnetic resonance (CMR) (figure 1C) was performed. Treadmill exercise test did not demonstrate any electrocardiographic ischaemic changes. No arrhythmias were noted on Holter monitor. Which of the following is most likely the diagnosis?
Supplementary file 1
Questions A: Lateral and inferolateral myocardial infarction
B: Congenital absence of pericardium
D: Congenital left ventricular outpouching
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YK and ZL contributed equally.
Funding This work was supported by grants No. 81401411 from the National Nature Science Foundation of China and No. 14ZR1425200 and No. 16ZR1420600 from Nature Science Foundation of Shanghai.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Renji Hospital Research Ethics Committee.
Provenance and peer review Not commissioned; internally peer reviewed.