ECG de noviembre de 2015

Abstract

A 25-year-old woman, in active employment, with no history of substance abuse, and no reported past medical history of note. Her father died of a heart condition 13 years before. There was no family history of heart disease or sudden death. She reported 2 months of progressive exertional dyspnea, inability to lie flat, and abdominal distention. On examination, heart sounds were regular, with a fourth heart sound, a grade 2/6 systolic murmur in the tricuspid area, significant jugular venous distention, tender hepatomegaly of 2 fingerbreadths, and signs of mild ascites. Her ECG is shown in the Figure. What would the diagnosis be?