The patient is a 42-year-old male who presents after referral from a diagnostic testing site with an abnormal ECG, obtained during a preoperative evaluation. He reports a history of hypertension and symptomatic inguinal hernia, and acknowledges chronic right groin pain. He is otherwise asymptomatic, including robust exercise tolerance.

View the ECG and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Tom Fadial, MD, The University of Texas Health Sciences Center of Houston McGovern Medical School.)

A 42-Year-Old Male with an Abnormal ECG
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