case_images: PMC3271679_01
case_images: In the left panels, 12-lead electrocardiogram (ECG)at the age of nine (2002), depicting sinus rhythm, PR interval 160 ms, QTc 380 ms and Q-waves in leads V5, V6 with negative T-waves. In the right panel, 12-lead ECG on admission at the age of sixteen (2009), depicting sinus rhythm; PR interval 130 ms and delayed left atrial depolarization (the second vector of the P-wave is delayed, most likely by fibrosis of the interatrial septum); deep Q-waves in leads I, aVL, V5, and V6, diffuse T-wave inversion, QRS duration 130 ms and different morphologies of fQRS, including various RSR  patterns
case_images: JCDR-3-32-g001.jpg
case_images: PMC3271679_01_JCDR-3-32-g001.jpg
case_images: F1
case_images: At that time, her 12-lead electrocardiogram (ECG) showed sinus rhythm, Q-waves and negative T-waves in leads V5 and V6 with a QRS duration < 120 ms. [Figure 1, left panel].
case_images: Parasternal large axis view (left) and apical four-chamber view (right) depicting global thickened of the left ventricular walls and right ventricle and interatrial septum involvement. IVS: interventricular septum; LA: left atria; LV: Left ventricle; RA: right atria; RV: right ventricle
case_images: JCDR-3-32-g002.jpg
case_images: PMC3271679_01_JCDR-3-32-g002.jpg
case_images: F2
case_images: During hospitalization, an echocardiogram showed massive left and right ventricular hypertrophy with a septal thickness of 38 mm and absence of intraventricular gradient [Figure 2].