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ECG (A) showing poor R wave progression in the anterior leads and prolonged PR interval consistent with first-degree AV block (arrow). Echocardiogram (B–E) findings showing unexplained concentric LVH (1.4 cm) with reduced lateral E velocity (4.46 cm/s) and mitral inflow consistent with diastolic dysfunction in the context of the ECG showing no evidence of LVH (discordance) in the absence of hypertension. ECG, electrocardiogram; LVH, left ventricular hypertrophy.
