Uribe Longoria A, Rodríguez Terrazas R, Treviño A J
Arch Inst Cardiol Mex. 1983 Nov-Dec;53(6):521-5.
A case of arrhythmogenic right ventricular dysplasia in a 27 year-old woman is presented, the first one published in Mexico. Palpitations and episodes of syncope were the most important symptoms. Ventricular premature beats and bigeminy without evidence of cardiomegaly or heart failure were disclosed on physical examination. Electrocardiograms revealed frequent, multifocal ventricular extrasystoles with complete left bundle branch block morphology suggesting a right ventricular origin. Dilatation, hypokinesia and decreased ejection fraction were found by both, bidimensional, echocardiography and radionuclear grammography. Right heart catheterization revealed normal pressures and confirmed the hypokinesia, dilatation and decreased ejection fraction; furthermore, irregularities in the endocardial contour of the right ventricle produced a "cauliflower-like" image. Lidocaine suppressed the episodes of ventricular tachycardia, but prevention of recurrences was only obtained with the administration of amiodarone. A review of the literature regarding the diagnosis of this disease is discussed; in addition to the clinical, anatomic and functional aspects above mentioned, an electrophysiological study may be indicated to confirm the right ventricular origin of the arrhythmias with re-entry mechanism.