Case 30-1982

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Abstract
Presentation of CaseA 49-year-old man was admitted to the hospital because of dyspnea and syncope.He was well until three months earlier, when dyspnea developed abruptly while he was walking up a short hill, and he lost consciousness briefly. He entered another hospital, where an electrocardiogram demonstrated a normal rhythm with a PR interval of 0.26 second and left-axis deviation. A 24-hour Holter-monitor recording showed rare premature atrial contractions and single premature ventricular contractions. An exercise-tolerance test disclosed no ectopic activity and provoked no chest pain. One month before admission exertional dyspnea recurred and progressed, and he returned to . . .

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