A 49-year-old patient suffering from recurrent effort lipothymia and palpitation was referred for cardiac catheterization. A diagnosis of marked hypertrophy of right ventricular outflow tract and double chamber right ventricle with intraventricular gradient of 50 mm Hg was made. Operation was delayed until age 49 when an anomalous intraventricular hypertrophic band was resected. The first 2D and Doppler echocardiogram after operation disclosed a previously unrecognised intraventricular septal defect. Three years after operation the patient is asymptomatic.
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