A 19-year-old man was referred for lipothymia, episodes of palpitations, and dyspnoea New York Heart Association class II. He had no previous personal medical history; however, his brother experienced sudden cardiac death at the age of 16 years. The physical examination showed a heart rate of 65 bpm and a blood pressure of 130/70 mm Hg; no signs of heart failure were found. Electrocardiogram (ECG) revealed sinus rhythm, incomplete left bundle branch block, and no ST-T segment abnormalities. Two-dimensional echocardiogram showed a dilated left ventricle (LV) with mild systolic dysfunction (ejection fraction [EF] 42%) and hypertrabeculated LV apex, dilated left atrium (area 27 cm 2
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