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A, Electrocardiogram showed sinus rhythm, lower voltage of limb leads, QTc prolongation (508 ms) and ST-T segment changes on leads II, III, aVF, and V4 through V6. B, Transthoracic echocardiogram revealed marked respiratory variation that was a 34% increase of mitral E velocity during expiration. C, Lateral Mitral annular movement that assessed on tissue Doppler imaging showed diastolic velocities (Em) was at lower normal limit (11 cm/s).
