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[The arrhythmogenic right ventricular cardiomyopathy (ARVC)].
K Wellemeyer1, S Röthemeyer, W Kranig
1Herzzentrum Osnabrück/Bad Rothenfelde, Ulmenallee 11, 49214 Bad Rothenfelde, Germany. Kardiologie@schuechtermann-klinik-de
Zeitschrift Fur Kardiologie
|December 10, 2003
Summary
This case report details a 40-year-old diagnosed with arrhythmogenic right ventricular cardiomyopathy (ARVC) presenting with ventricular tachycardia (VT). Diagnosis was confirmed via imaging and electrophysiology, highlighting typical and inconspicuous ARVC features.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Imaging
Context:
- A 40-year-old patient presented with symptomatic sustained ventricular tachycardia (VT).
- Initial assessments excluded obstructive coronary artery disease and confirmed preserved left ventricular function.
- Right ventricular abnormalities were suspected based on surface ECG findings.
Purpose:
- To present a case of arrhythmogenic right ventricular cardiomyopathy (ARVC) with a typical presentation.
- To illustrate diagnostic findings including ECG, angiography, MRI, and electrophysiological study.
- To highlight that ARVC can manifest with morphologically inconspicuous arrhythmogenic areas in the right ventricle.
Summary:
- Ventricular tachycardia (VT) with left bundle branch block morphology and inferior axis was documented.
- Right ventricular angiography and MRI revealed reduced function, regional contraction abnormalities, outpouchings, bulgings, and fatty infiltrations.
- Electrophysiological study confirmed reproducible VT originating from the RVOT, meeting McKenna criteria for ARVC diagnosis.
Impact:
- The case underscores the importance of comprehensive diagnostic evaluation for ARVC.
- It demonstrates that subtle or inconspicuous right ventricular abnormalities can be associated with ARVC.
- The patient received an ICD and medical management with metoprolol for the diagnosed ARVC.