Department of Cardiology, San Filippo Neri Hospital, Italy.
J Cardiovasc Med (Hagerstown). 2010 Jan;11(1):59-60. doi: 10.2459/JCM.0b013e32832cea33.
A 48-year-old man with an episode of syncope and family history of sudden cardiac death was evaluated. The ECG showed negative T waves from V1 to V3 with evidence of epsilon-wave. Magnetic resonance imaging showed replacement with fibrofatty tissue in midapical regions of free wall of the right ventricle with dyskinesia. Transthoracic echocardiography revealed only mild enlargement of the middle right ventricular cavity. A programmed ventricular stimulation induced only an unsustained monomorphic ventricular tachycardia. Intracardiac echocardiography showed mild right ventricular enlargement and outflow dilatation (26 mm), microaneurysms with systolic bulging along the apical segment of the right ventricle. Bipolar voltage mapping, performed by the Carto system, detected a circumscribed low potential (<1.5 mV) area at the same level of the right ventricular apex. Cardiovascular imaging improves the detection of abnormal myocardial areas. Further studies are warranted to support this hypothesis.
一位 48 岁男性因晕厥发作和家族性心源性猝死史就诊。心电图显示 V1 至 V3 导联 T 波倒置，伴有 ε 波。磁共振成像显示右心室游离壁中上部呈纤维脂肪组织替代，运动障碍。经胸超声心动图仅显示右心室中腔轻度扩大。程控心室刺激仅诱发非持续单形性室性心动过速。心腔内超声显示右心室轻度扩大和流出道扩张（26mm），伴有心尖段右心室的微动脉瘤和收缩期膨出。Carto 系统行双极电压标测，于右心室心尖同一水平检测到局限的低电压区（<1.5mV）。心血管影像学可提高异常心肌区域的检出率。需要进一步研究来支持这一假说。
