Case 166

Abstract

A 6-ft 3-in., 16-year-old male who was a high-school varsity soccer and basketball player was referred to pediatric cardiology to rule out Marfan's syndrome based on his tall slim body habitus and occasional joint aches. The patient denied any history of palpitations, shortness of breath, or chest discomfort with exertion. He did mention that occasionally he became slightly lightheaded or dizzy at the end of a game, but would always feel better after a few minutes of rest. These occasional episodes of lightheadedness had not caused him or his family enough concern to seek medical attention. The patient's family history was unremarkable for sudden cardiac death, with the exception of his maternal great-grandmother who had a seizure disorder and died at the age of 36 of unknown causes. Physical exam was normal. An echocardiogram showed no structural heart disease and no anomalous coronary origin. The patient's electrocardiogram (ECG) is shown below (Fig. 166.1). What is the likely diagnosis and what is the best management option for this patient? © Springer-Verlag London Limited 2011.