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Twenty-five-year-old woman with palpitations and hypertrophic cardiomyopathy
  1. Krittapoom Akrawinthawong,
  2. Vineet Kumar
  1. Cardiovascular Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
  1. Correspondence to Dr Krittapoom Akrawinthawong, Cardiovascular Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA; krittapoom.a{at}


Clinical introduction A 25-year-old woman with a diagnosis of hypertrophic cardiomyopathy (HCM) and pre-excitation on ECG presented with unexplained syncope and daily palpitation. Genetic testing was positive for lysosome-associated membrane protein 2 (LAMP2) mutation which confirmed the diagnosis of Danon disease. Her younger sister was diagnosed with a similar condition and received a defibrillator implantation. Her 12-lead ECG (figure 1) and a long strip tracing (figure 2) are shown below.

Question Where is the location of the accessory pathway and what is the next appropriate management?

  1. Anteroseptal pathway and catheter ablation

  2. Mid-septal pathway and pacemaker/defibrillator implantation

  3. Right lateral pathway and catheter ablation

  4. Fasciculoventricular pathway and electrophysiological study

  5. Left lateral pathway and electrophysiological study

  • sudden cardiac death
  • WPW syndrome
  • cardiomyopathy hypertrophic

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  • Contributors KA and VK wrote and revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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