Case Report: Arrhythmogenic Right Ventricular Dysplasia

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is a genetic disorder that increases risk of sudden cardiac death in young people. Its pathophysiology primarily involves fibro-fatty infiltration of the myocardium and subsequent cardiomyopathy and arrythmias. There are some interesting EKG findings associated with ARVC. Exact incidence is unknown but estimated to be between 1/2000-1/5000.

We present a 25-year-old female with significant family history of AVRC, who presented with palpitations. We discuss her initial EKG findings of T wave changes in Right precordial leads. Subsequent 2D Echo showed global biventricular dysfunction and reduced EF. She was started on GDMT for non-ischemic cardiomyopathy. MRI showed classic findings of ARVC, and the patient underwent genetic testing which was positive. Her subsequent clinical course and outpatient follow up with Cardiology specialists are discussed. We also go into a brief review of pathophysiology and classic EKG findings of ARVC.

Early recognition of this underrecognized pathology can lead to better outcomes with early ICD placement and pharmacological therapy.