Riasat Maria, Khan Arshan, Meghrajani Vineet, Gaikwad Mrunalini, Gill Rajwinder
Internal Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York City, USA.
Internal Medicine, Ascension St. John Hospital, Detroit, USA.
Cureus. 2022 May 10;14(5):e24872. doi: 10.7759/cureus.24872. eCollection 2022 May.
Arrhythmogenic right ventricular dysplasia (ARVD) is a heart muscle disease that predominantly affects the right ventricle; however, biventricular involvement is increasingly being recognized. Fibrofatty tissue replacement is a central feature of ARVD. The majority of the identified genes, including protein plakophilin-2 (PKP-2), involved in cell-to-cell adhesion, can be seen in most genetic cases. Clinically, affected individuals present with palpitations, syncope, or sudden death due to ventricular arrhythmias, such as ventricular tachycardia (VT) or fibrillation, with symptomatic heart failure usually only in later stages. In this study, we present a male patient with ARVD who underwent a genetic test that revealed ARVD with PKP-2 mutation after multiple admissions for heart failure and arrhythmias. He ultimately underwent orthotopic heart transplantation (OHT). Early detection is important for further management, risk stratification, and reduced hospitalization in patients with ARVD.
致心律失常性右室心肌病(ARVD)是一种主要累及右心室的心肌疾病;然而,双心室受累越来越受到认可。纤维脂肪组织替代是ARVD的核心特征。在大多数遗传病例中可见到大多数已鉴定出的与细胞间黏附有关的基因,包括桥粒斑菲素蛋白-2(PKP-2)。临床上,受影响个体因室性心律失常,如室性心动过速(VT)或颤动而出现心悸、晕厥或猝死,有症状的心力衰竭通常仅在后期出现。在本研究中,我们报告了一名患有ARVD的男性患者,该患者在因心力衰竭和心律失常多次入院后接受了基因检测,结果显示为伴有PKP-2突变的ARVD。他最终接受了原位心脏移植(OHT)。早期检测对于ARVD患者的进一步管理、风险分层和减少住院至关重要。