MJB, Caucasian, male, 31, tattooist, was admitted in our emergency room (ER) with complaint of prolonged atypical chest pain in August 23-2008 19:30 P.M.
Pathological personal antecedents: carrier of polycystic kidney disease (PKD) and hypertension (using captopril 25mg (3x/day) and hydrochlorothiazide 25mg (1 tablet daily)).
He does not refer syncope, sudden cardiac death (SCD) and heart failure (HF).
Negative familial background for syncope or SCD in firth degree relatives
Physical examination: lucid, BP = 140/100 mmHg, bradycardic (heart rate 40 bpm) regular with hyperphonetic 2nd heart sound A2.
Laboratory: Normal biomarkers and electrolytes.
Echocardiogram: Normal.
Normal coronary angiography (unfortunately, the picture was interpreted erroneously as acute coronary syndrome (ACS). Electrophysiological Study (EPS) with Programmed Ventricular Stimulation (PVS) or Programmed Electrical Stimulation (PES) conducted to polymorphic VT that degenerated into VF.
Implanted Implantable Cardioverter Defibrillator (ICD) was indicated following the last guidelines (Class IIb indication) (Priori 2013).