Left ventricular hypertrophy in a young adult.

A 21-year-old male was referred for investigation of complaint of chest pain associated with breathlessness duringexertion. There was no history of leg swelling, orthopnoea or paroxysmal nocturnal dyspnoea. He had no history of hypertension, family history of heart disease or sudden death. On clinical examination, he was well built. The blood pressure was normal. The pulse had a jerky nature. There was an additional fourth heart sound and a short late systolic murmur over the left sternal edge.