Clinical Manifestations and Diagnostic Approach to Arrhythmogenic Right Ventricular Cardiomyopathy – A Case Report and Literature Review

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare inherited disorder, which is characterized by fibrofatty degeneration of cardiac muscles mainly in the right ventricular myocardium. It may cause tachyarrhythmias or right-heart failure or may cause sudden death, especially in young athletes. In our case report, we present a case of young age male patient who presented at a local community hospital with the complaint of atypical chest pain, palpitations, and vomiting and sustained ventricular tachycardia (VT) on electrocardiograph (ECG) showing sustained VT, left bundle branch morphology with the superior axis. The normal sinus rhythm was achieved after multiple direct current (DC) cardioversion attempts, and he was referred to our tertiary care hospital. Later ECG demonstrated epsilon waves and T wave inversion in V1 to V4 and right bundle branch block (RBBB) morphology. The echocardiography showed a severely dilated right ventricle with dysfunction and right ventricle ventricular apical aneurysm. The definitive diagnosis of ARVC was made as per Revised Task Force Criteria 2010, and the electrophysiology review suggested implantable cardiac defibrillator (ICD) device placement. The patient successfully received a dual-chamber ICD device, and he remained asymptomatic.