Marked Septal Dyskinesis From Wolff-Parkinson-White Syndrome

A 4-year-old Hispanic male presented with an isolated episode of vomiting and syncope. The clinical history was otherwise unremarkable, and he appeared well on clinical examination.His initial resting ECG demonstrated ST-segment abnormalities and increased voltages; there was no ventricular preexcitation (Figure 1A). Transthoracic echocardiography revealed marked dyskinesis of the basal interventricular septum with aneurysmal septal movement into the right ventricle (Figure 2A and 2B and Movies I and II in the online only …