PMC3262492_01
Electrocardiogram taken during maximal exercise. Note the configuration of QRS, with a left bundle branch block pattern, right axis deviation, and positive deflections in leads DII, DIII, and aVF. VT was preceded by single and couplet ventricular extrasystoles with a similar configuration.
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fig1
As her symptoms appeared during exercise, an exercise ECG was performed, and during test, numerous ventricular extrasystoles with a LBBB pattern and positive QRS in leads DII-DIII-aVF ensued and succeeded by sustained ventricular tachycardia with a similar configuration (Figure 1).
(a) Cardiac MR of the patient taken at diastole. Numerous hypertrabeculated segments with deep intertrabecular recessus separating them are visible in the mid segment of the lateral left ventricle (Arrowheads). Also note that the right ventricle was not affected by the disease process and fibrofatty infiltration was not present (asterisk). (b) Cardiac MR of the patient taken at systole (arrowheads). An endocardial-to- epicardial ratio of 2 in the lateral left ventricular wall was measured in the still frames taken at end-systole.
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fig2
CMR revealed similar results with an endocardial-epicardial myocardial ratio of 2 (Figure 2).