Mr E is a 22-year-old college hockey player. Major features of his past medical history include right-sided necrotizing pneumonia requiring chest tube placement at age 15, a concussion sustained while playing ice hockey at age 19, and patellar dislocation at age 21. On October 25, 2020, he developed new onset upper respiratory symptoms possibly as a result of becoming infected with SARS-CoV-2, the pathogen causing COVID-19. This prompted the need for a clinical evaluation by his primary care physician, including undergoing testing for COVID-19, which returned negative.

Initial cardiac-specific testing carried out during Mr E's primary care clinical evaluation included a resting 12-lead electrocardiogram (ECG) study, which revealed a normal sinus rhythm but with delta waves (Figure 1) consistent with ventricular preexcitation. This observation prompted a referral to cardiology where it could be viewed on follow-up serial ECG studies that...

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