Description

A 40-year-old female patient, who was found to have diabetes mellitus during her first pregnancy, and then developed difficulty in hearing, was diagnosed as suffering from mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) due to mutation of mitochondrial DNA (A3243G). The patient complained of palpitation and faintness; ECG demonstrated short PQ interval with normal QRS width and significant ST-segment depression in II, III, aVF and V4-6 (figure 1). Echocardiogram and coronary CT angiogram showed normal findings. Then, electrophysiological study and myocardial biopsy were performed.