title: Arrhythmogenic right ventricular cardiomyopathy mimics: role of cardiovascular magnetic resonance.
abstract: BACKGROUND
  Cardiovascular magnetic resonance (CMR) is commonly used in patients with suspected arrhythmogenic right ventricular cardiomyopathy (ARVC) based on ECG, echocardiogram and Holter. However, various diseases may present with clinical characteristics resembling ARVC causing diagnostic dilemmas. The aim of this study was to explore the role of CMR in the differential diagnosis of patients with suspected ARVC.
  
  
  METHODS
  657 CMR referrals suspicious for ARVC in a single tertiary referral centre were analysed. Standardized CMR imaging protocols for ARVC were performed. Potential ARVC mimics were grouped into: 1) displacement of the heart, 2) right ventricular overload, and 3) non ARVC-like cardiac scarring. For each, a judgment of clinical impact was made.
  
  
  RESULTS
  Twenty patients (3.0%) fulfilled imaging ARVC criteria. Thirty (4.6%) had a potential ARVC mimic, of which 25 (3.8%) were considered clinically important: cardiac displacement (n=17), RV overload (n=7) and non-ARVC like myocardial scarring (n=4). One patient had two mimics; one patient had dual pathology with important mimic and ARVC. RV overload and scarring conditions were always thought clinically important whilst the importance of cardiac displacement depended on the degree of displacement from severe (partial absence of pericardium) to epiphenomenon (minor kyphoscoliosis).
  
  
  CONCLUSIONS
  Some patients referred for CMR with suspected ARVC fulfil ARVC imaging criteria (3%) but more have otherwise unrecognised diseases (4.6%) mimicking potentially ARVC. Clinical assessment should reflect this, emphasising the assessment and/or exclusion of potential mimics in parallel with the detection of ARVC major and minor criteria.
authors: The Heart Hospital, University College London Hospitals Trust, London, UK.
authors: Giovanni
authors: G
authors: Quarta
authors: Syed I
authors: SI
authors: Husain
authors: Andrew S
authors: AS
authors: Flett
authors: Daniel M
authors: DM
authors: Sado
authors: Charles Y
authors: CY
authors: Chao
authors: Marıá T
authors: MT
authors: Tomé Esteban
authors: William J
authors: WJ
authors: McKenna
authors: Antonios
authors: A
authors: Pantazis
authors: James C
authors: JC
authors: Moon
mesh_terms: D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D008131:London; D019028:Magnetic Resonance Imaging, Cine; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right
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