A large right ventricular mass in a 42-year-old female marathon runner

A 42-year-old female marathon runner presented with an exercise-related tachycardia. A 12-lead-surface electrocardiogram (ECG) showed sinus rhythm with T inversion in the precordial leads and ventricular ectopic beats originating from the right ventricular outflow tract (RVOT) ( Panel A ). Echocardiography showed a mildly dilated right ventricle (RV) with normal global function and no pulmonary …