Arrhythmogenic right ventricular cardiomyopathy (ARVC): incidental finding in the evaluation of acute chest pain
DOI:
https://doi.org/10.26871/killkana_salud.v10i1.1750Keywords:
Arrhythmogenic Right Ventricular Cardiomyopathy, Acute Myocardial Infarction, ST-segment elevation, Magnetic Resonance Imaging, Differential DiagnosisAbstract
Introduction: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an autosomal dominant inherited disorder characterized by structural and functional alterations of the right ventricle due to the replacement of myocardial tissue with fibro-adipose tissue. It is associated with a high risk of ventricular arrhythmias and sudden death, due to mutations in genes affecting desmosomal proteins, which lead to cellular dysfunction and myocyte death. Diagnosis is based on criteria established by the International Task Force. Clinical case: A 65-year-old male patient with no significant medical history presented with precordial pain. The electrocardiogram revealed ST-segment elevation in the precordial leads, along with progressively elevated troponin levels. The patient was initially diagnosed with acute myocardial infarction. Coronary angiography was performed, ruling out obstructive coronary artery disease. Subsequently, cardiac magnetic resonance imaging confirmed the diagnosis of ARVC. The patient showed a favorable clinical course, with complete normalization of the electrocardiographic findings. Treatment consisted of anti-inflammatory agents, beta-blockers, and restriction of physical activity. Conclusion: ARVC may mimic acute myocardial infarction with ST-segment elevation and elevated troponin levels. Clinical stability and the absence of coronary lesions should prompt further evaluation with cardiac magnetic resonance imaging to ensure timely diagnosis and appropriate management.
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