Potassium: 3.7. Creatinine: 0.9. Glucose: 120. Magneisum: 1.7. Hgb: 13.0. MCV: 79. Troponins 0.66 then 6.0. TSH 12.1. free T4: 0.96. Urine toxicology negative. Urine pregnancy negative. Chest radiograph without infiltrates or cardiac enlargement. D-dimer negative.
1st EKG: Wide complex tachycardia at 225 bpm, left bundle left inferior axis.
2nd EKG after resolution of wide complex tachycardia: T-wave inversions in V1-V3 and multiform PVCs.
Transthoracic echocardiogram: Normal LV size and function. Concern for RV apical hypokinesis. No valvular abnormalities.
Cardiac catheterization with coronary angiography: Angiographically normal coronary arteries. Left ventricular end diastolic pressure normal.
Cardiac MRI: Decreased RVEF at 32%. Borderline low LVEF at 54%.
Electrophysiology study: Several PVC morphologies noted; predominately left bundle axis and superiorly oriented. No inducible tachycardia.
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