The ECG of a (Cardio)myopathy?
|Author(s)||A.A.M. Wilde, Y.M. Pinto|
|These Rhythm Puzzles have been published in the Netherlands Heart Journal and are reproduced here under the prevailing creative commons license with permission from the publisher, Bohn Stafleu Van Loghum.|
|The ECG can be enlarged twice by clicking on the image and it's first enlargement|
A 33-year-old lady visited the cardiologist because of the sudden death of her brother at age 35. He died while watching TV and had been without symptoms as far as she was aware. Her father received a pacemaker at the age of 48. She had no complaints of dizziness, palpitations, dyspnoea or chest pain. Her only complaint was some weakness in her arms shortly after lifting them to get something from above her head. Physiological examination did not reveal any peculiarities. Her ECG is shown in figure 1. Her echocardiogram is normal, although cardiac dimensions were at the upper limit of normal. What is your diagnosis and what would your next step be?