Death of a young man with left axis deviation

Abstract

A 24 yr old Thai man with essentially normal physical signs and chest X ray had fainting spells and shortness of breath associated occasionally with exertion and occasionally with low substernal epigastric pain. His ECG showed left axis deviation compatible with anterior fascicular block and ST T changes of lateral wall ischemia. Clinical study did not reveal anything abnormal except for the elevation of the left ventricular end diastolic pressure. The patient died about 5 mth after the onset of his first symptom. His clinical study and the terminal event suggests primary myocardial failure due to an 'obscure myocardial disorder'.