{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T16:35:40Z","timestamp":1757608540498,"version":"3.44.0"},"reference-count":2,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Emerg Med J"],"accepted":{"date-parts":[[2018,2,13]]},"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec id=\"s1\">\n                  <jats:title>Clinical introduction<\/jats:title>\n                  <jats:p>A 17-year-old male\u00a0patient was brought by ambulance to the ED following a witnessed collapse while playing rugby. He denied any significant trauma, chest pain or breathlessness, and was alert and uncomplaining on arrival, with normal observations and a normal physical exam. Witnesses described a loss of consciousness, with a period of respiratory arrest requiring rescue breaths at the scene. Paramedics reported frequent ventricular extrasystoles on their arrival.<\/jats:p>\n                  <jats:p>The patient had no medical history and was on no medication, although admitted to \u2018fainting\u2019 some 3\u2009weeks previously, again while playing rugby. A paternal uncle had died suddenly at the age of 45.<\/jats:p>\n                  <jats:p>His initial ECG is shown in figure 1.<\/jats:p>\n                  <jats:fig id=\"F1\" position=\"float\" orientation=\"portrait\">\n                     <jats:label>Figure 1<\/jats:label>\n                     <jats:caption>\n                        <jats:p>Initial ECG.<\/jats:p>\n                     <\/jats:caption>\n                     <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"emermed-2017-207434f1\" position=\"float\" orientation=\"portrait\"\/>\n                  <\/jats:fig>\n               <\/jats:sec>\n               <jats:sec id=\"s2\">\n                  <jats:title>Question<\/jats:title>\n                  <jats:p>What is the most likely diagnosis?<jats:list list-type=\"alpha-upper\">\n                        <jats:list-item>\n                           <jats:p>Pulmonary embolism (PE)<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                           <jats:p>Hypertrophic obstructive cardiomyopathy (HOCM)<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                           <jats:p>Arrhythmogenic right ventricular cardiomyopathy (ARVC)<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                           <jats:p>Right ventricular outflow tract tachycardia (RVOT)<\/jats:p>\n                        <\/jats:list-item>\n                     <\/jats:list>\n                  <\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/emermed-2017-207434","type":"journal-article","created":{"date-parts":[[2018,3,5]],"date-time":"2018-03-05T12:15:18Z","timestamp":1520252118000},"page":"764-772","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Collapse in the scrum"],"prefix":"10.1136","volume":"35","author":[{"given":"David","family":"Donnelly","sequence":"first","affiliation":[{"name":"Emergency Department, Hairmyres Hospital, East Kilbride, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Patrick","sequence":"additional","affiliation":[{"name":"Emergency Department, Hairmyres Hospital, East Kilbride, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin A","family":"Weir","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hairmyres Hospital, East Kilbride, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,3,5]]},"reference":[{"key":"2025090222055506000_35.12.764.1","doi-asserted-by":"crossref","first-page":"CMC.S10940","DOI":"10.4137\/CMC.S10940","article-title":"Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC\/D): A Systematic Literature Review","volume":"7","author":"Romero","year":"2013","journal-title":"Clin Med Insights Cardiol"},{"key":"2025090222055506000_35.12.764.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.840827"}],"container-title":["Emergency Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/emermed-2017-207434","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T05:06:04Z","timestamp":1756875964000},"score":1,"resource":{"primary":{"URL":"https:\/\/emj.bmj.com\/lookup\/doi\/10.1136\/emermed-2017-207434"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,5]]},"references-count":2,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2018,11,21]]},"published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1136\/emermed-2017-207434"],"URL":"https:\/\/doi.org\/10.1136\/emermed-2017-207434","relation":{},"ISSN":["1472-0205","1472-0213"],"issn-type":[{"type":"print","value":"1472-0205"},{"type":"electronic","value":"1472-0213"}],"subject":[],"published":{"date-parts":[[2018,3,5]]}}}