Unusual case of the left ventricular aneurysmatic involvement in arrhythmogenic right ventricular cardiomyopathy
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Unusual case of the left ventricular aneurysmatic involvement in arrhythmogenic right ventricular cardiomyopathy Hamayak Sisakian
Arrhythmogenic right ventricular cardiomyopathy is an inherited myocardial disease characterized by fibro-fatty replacement of the right ventricle and is considered the second most prevalent cause of sudden cardiac death in young and athletes. The disease is usually manifested by paroxysms of life-threatening ventricular arrhythmias. In this report, we present a case of a 46 years old male who referred to our clinic with complains of palpitations and irregular heartbeats.
The patient presented with a history of palpitations for many years for which he received amiodarone and bisoprolol. During hospital treatment, he developed a paroxysm of hemodynamically unstable wide complex ventricular tachycardia which was treated by electrical cardioversion. The coronary angiography of the patient did not detect any haemodynamically significant stenoses of coronary arteries. The echocardiographic examination revealed concentric hypertrophy of the left ventricle, enlargement of right ventricle and right atrium. The aneurysm was present in the subvalvular region and along the lateral wall of right ventricle right ventricle. The patient was preliminary diagnosed with stable ventricular tachycardia, syncope, arrhythmogenic shock, status after electrical cardioversion and arrhythmogenic right ventricular cardiomyopathy. The
cardiac magnetic resonance study was performed for confirmation of clinical diagnosis which revealed the presence of left ventricle aneurysm, right ventricle free wall aneurysm and dilatation. The late gadolinium enhancement revealed the presence of right ventricle fibrosis. The presented case demonstrates that biventricular involvement may be undetected by echocardiography, and cardiac magnetic resonance study with increased experience to interpret myocardial structural and tissue characteristics is considered the most accurate diagnostic technique in arrhythmogenic right ventricular cardiomyopathy.
DOI: https://ysmu.am/v2/wp-content/uploads/2023/09/13-unu.pdf The New Armenian Medical Journal Vol.14 (2020), Nо 2 100-104
