Author + information
- Andy Kieu,
- Dhruv Chawla and
- Louie Kostopoulos
Arrhythmogenic right ventricular cardiomyopathy (ARVC), a genetic disorder that causes myocardium replacement with fibrofatty tissue, is a cause of cardiac arrest in athletes.
A 62-year-old athletic man presented with palpitations. Maternal family history was significant for sudden cardiac death (SCD). Electrocardiogram (ECG) showed monomorphic ventricular tachycardia with left bundle branch pattern. The patient was cardioverted because of persistent symptomatic arrhythmia despite antiarrhythmics. Subsequent ECG showed sinus bradycardia with deep inverted T waves in leads V3-6.
Given concern for apical hypertrophic cardiomyopathy, further testing was done. Echocardiogram noted biventricular systolic dysfunction, which added concern for myocarditis. Coronary angiogram ruled out ischemic causes. Cardiac magnetic resonance imaging (MRI), obtained to help narrow the diagnosis, showed global left ventricular hypokinesis and severely dilated right ventricle (end diastolic volume index of 140 mL/m2) with global hypokinesis and free wall akinesis. Provided the family history of SCD and above-mentioned findings, he was diagnosed with ARVC.
We present an intriguing case of ARVC diagnosed in an athletic man with a family history of sudden death. Secondary prevention measures (implantable cardioverter defibrillator), beta blockers, lifestyle modifications and genetic testing were all advised.
Poster Hall, Hall A/B
Monday, March 12, 2018, 9:45 a.m.-10:30 a.m.
Session Title: FIT Clinical Decision Making: Arrhythmia and Electrophysiology
Abstract Category: Arrhythmias and Clinical EP
Presentation Number: 1282-115
- 2018 American College of Cardiology Foundation