A 28-year-old white man was admitted to our intensive care unit for acute chest pain; he was known to have a MVP and his risk factors were limited to active smoking and a family history of coronary heart disease. The admission ECG showed T-wave inversions and mild ST-segment elevation in the inferior leads ( Fig. 1 ), suggesting an ACS. There were no reciprocal changes (normal ST segment in the anterior leads). Antiplatelet therapy and heparin were initiated. Cardiac biomarkers were negative and after 48 hours ECG abnormalities remained unchanged. Transthoracic echocardiography confirmed the MVP without any wall motion abnormalities or other valvular anomaly ( Fig. 2 ). A cardiac stress test was negative, suggesting the absence of myocardial ischaemia. Afterwards, we found that the results of an ECG done several months earlier were similar. Thus, we concluded MVP associated with inferior repolarization abnormalities. The patient was discharged without medication. Nine months later, the patient remained asymptomatic and the ECG was unchanged.
