title: Arrhythmogenic right ventricular dysplasia/cardiomyopathy presenting as ST-segment elevation myocardial infarction: a case report.
abstract: Diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is often challenging due to differing clinical presentations and unpredictable progression of the disease. We report a case of ARVD/C that presented as cardiac arrest in an 18-year-old male while playing soccer. The electrocardiographic features after resuscitation were typical of anterior ST-segment elevation acute myocardial infarction, and the patient was initially managed accordingly. Importantly, an urgent coronary angiogram revealed completely normal coronary arteries. ARVD/C was first suspected following an echocardiogram, and was later confirmed by cardiac magnetic resonance. One month before the event, the patient had been evaluated for ventricular extrasystoles and an abnormal resting electrocardiogram, however ARVD/C was ruled out because of the presence of only two minor diagnostic criteria (T-wave inversion in anterior precordial leads in the absence of right bundle branch block and more than 1000 ventricular extrasystoles during 24-h Holter monitoring). In consequence, physical activity was not forbidden. In conclusion, this case report enforces the need for a strict prohibition of physical activity and serial evaluation of individuals with only minor diagnostic criteria for ARVD/C, for lacking sensibility of Task Force diagnostic criteria.
authors.affiliation: Divisione di Cardiologia, Ospedale Civile "San Pellegrino", Via Garibaldi 65, 46043 Castiglione delle Stiviere, (MN) Italy. andreapacchioni@gmail.com
authors.forename: Andrea
authors.initials: A
authors.lastname: Pacchioni
authors.forename: Carlo
authors.initials: C
authors.lastname: Angheben
authors.forename: Paolo
authors.initials: P
authors.lastname: Pellegrini
authors.forename: Daniele
authors.initials: D
authors.lastname: Prati
authors.forename: Marco
authors.initials: M
authors.lastname: Turri
authors.forename: Maria Antonia
authors.initials: MA
authors.lastname: Prioli
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Agostoni
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.forename: Corrado
authors.initials: C
authors.lastname: Vassanelli
mesh_terms: D000293:Adolescent; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology