Fig. 2

a Transthoracic echocardiography (TTE) showed a normal left ventricular systolic and dyastolic function, no valve dysfunction, mild right ventricular enlargement with normal function at rest. b An echocardiogram was performed by physical exertion. The test was interrupted for dyspnea and desaturation (SATO2 84%) and a value of 65 mm/Hg estimated pulmonary pressure was detected. At the ECG appearance of slightly down sloping ST tract and incomplete right bundle block