AbstractKearns‐Sayre syndrome was diagnosed in a 40‐year‐old female patient admitted for evaluation of symptomatic bradycardia. In addition to the classic triad—external ophthalmoplegia, pigmentary retinopathy, and heart block—she also had secondary amenorrhea, hearing loss, diabetes, and increased concentrations of blood lactate and pyruvate as manifestations of this multisystem disease. The echocardiographic examination disclosed asymmetric septal hypertrophy with a septal diastolic thickness of 17 mm and a septum to free wall ratio of 1.5. The left ventricular size and function were normal. Thus, asymmetric' septal hypertrophy may represent subclinical heart muscle involvement in Kearns‐Sayre syndrome.
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