title: A unique association of arrhythmogenic right ventricular dysplasia and acute myocarditis, as assessed by cardiac MRI: a case report.
abstract: Arrhythmogenic right ventricular dysplasia (ARVD), is a genetic disorder of the heart, which mainly involves the right ventricle. It is characterized by hypokinetic areas at the free wall of the right ventricle (RV) or both ventricles, where myocardium is replaced by fibrous or fatty tissue. ARVD is an important cause of ventricular arrhythmias in children and young adults. Although the transmission of the disease is based on hereditary, in young adults it may not show any symptoms. The main differential diagnoses with other frequent etiological causes of sudden arrhythmia are: idiopathic outflow tract ventricular tachycardia of the RV, myocarditis, dilated cardiomyopathy and sarcoidosis.
  
  
  
  We describe an unusual case of a 44-year-old woman who was hospitalized for ventricular tachycardia, deep asthenia and dyspnoea with no previous history of cardiac disease. The patient had a ten-year history of palpitations, which started immediately after her last pregnancy. She was diagnosed with both acute/subacute viral myocarditis and arrhythmogenic right ventricular dysplasia, based on established clinical and cardiac MRI criteria. After the diagnosis the patient received an automatic implantable cardioverter defibrillator. Currently, she is on clinical follow-up with no apparent further complications.
  
  
  
  Analyzing this rare case, we have shown the link between myocarditis and arrhythmogenic right ventricular dysplasia, and how important is to perform a cardiac MRI, in the context of acute myocarditis and ventricular arrhythmia.
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80123, Naples, Italy. andreaponsiglione@hotmail.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ponsiglione
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80123, Naples, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Puglia
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80123, Naples, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Morisco
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80123, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Barbuto
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80123, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rapacciuolo
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80123, Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Santoro
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80123, Naples, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Spinelli
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80123, Naples, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80123, Naples, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cuocolo
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80123, Naples, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Imbriaco
mesh_terms: D000208:Acute Disease; D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D017147:Defibrillators, Implantable; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D009206:Myocardium / Q000473:pathology*
keywords: Cardiac; Case report; Magnetic resonance imaging; Myocarditis; Right ventricle