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Is it an ARVD?

added by Emmel

Is it an ARVD?
Comments
Posted By: ohtusabes (1929 days ago)

Hi Jörg. Impressive case.

I think this diagnosis explains
at all PH...if is sarcoidosis maybe some myocardial infiltration?/>
Best
Pablo

Posted By: Emmel (1929 days ago)

Hello friends!
You´re right! The suspicion of AVRD was the first
impression if I saw the ECG with an isolated right-ventricular
prolongation and that ECG. But the most criterias of AVRD are not
complied.
I´m very, very sorry I have to confess that I forgot
to tell you the solution of that case days later I´ve posted that
vid:
> no acute pulmonary embolism.
> no signs of chronic
thrmobembolic pulmonary embolism in HR-ct-scan
> no elevation of
PCWP (PCWP-approach by using E/E`by echocardiographic measurement./>> we found mediastinal lymphoma (DD: Sarkoidose) with pulmonary
infiltration (DD: reticular alteration by sarkoidose); That is in my
opinion the plausible reason for that pulmonary hypertension. />Best wishes and thank for comments,

(But by the way in my
opinion the RV looks very suspicious)

Jörg.

Posted By: ohtusabes (1931 days ago)

Hello my friends.
Like drdavemd says... first rule out the list
of causes of PH...(with 22 yo and if is female i will think in some
immune mediated condition)...
And with respect to ARVD look the
whole criteria here:/>http://circ.ahajournals.org/content/121/13/1533.full.pdf+html/>
Best
Pablo

Posted By: drdavemd (1931 days ago)

Any other reasons for PA pressure elevation? Chronic pulmonary emboli?
Pulmonary arterial hypertension? Did diastolic parameters suggest
elevated LVEDP?

Posted By: magehana47 (1937 days ago)

It is always a challenge to diagnose ARVD with echo only.i remind u to
read the proposition to modification of the task force criteria for
arvd published in 2010 in circulation and european heart
journal(EHJ(2010)31,806-814).

Posted By: Emmel (1938 days ago)

Please, only serious comments, hints and tipps. NO spam or
advertisement. This is the wrong place for such kind of stuff. Thanks
alot for understanding.


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Added: 04-04-2012
Runtime: 0m 9s
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Description

about 22 y old patient with new oedema of lower limb. In TTE we could see an enlarged right ventricle with good RV-function (TAPSE about 23 mm, TASV about 11 cm/sec) despite of a pulmonary hypertension of about 45 mmHg + CVP. There is no SCD in family history, no syncope, no arrhythmics. In ECG we could see an isolated right-ventrcular prolongation (QRS 1-3/QRS 4-6 = 1,39!!). What do you think could this be an ARVD? Do you know some specific echocardiographic signs of this kind of cardiomyopathy?


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