<prompt> A 20 year old patient presents with syncope. His current ECG is shown below. His elder brother had died suddenly while watching television. The patient was given Cardioversion and subsequent cardiac MRI revealed fibro-fatty changes in RV myocardium. What is the diagnosis of this patient?Hyperophic obstructive CardiomyopathyArythmogenic RV dysplasiaBrugada syndromeTako- Tsubo Cardiomyopathy  <response>: Arythmogenic RV dysplasiaARVD ECG shows HR of 300min with broad complex tachycardia. Variation in amplitude of QRS complexes which indicates a diagnosis of polymorphic Ventricular Tachycardia. In acute setting DC shock 200 J Biphasic should be given. The Cardiac MRI repo showing fibro-fatty changes in RV myocardium explains that the substrate for initiation of Polymorphic VT is originating from RV. This confirms the diagnosis as Arythmogenic RV dysplasiaARVD ECG - Presence of Epsilon wave. 