Young man with dilated and arrhytmogenic right ventricle
Brazil
Case presentation
J.P.S.F, male, 26 years old, born in Itatira-CE, Brazil, single, farmer Main complaint:
Patient, admitted in this service on July 22nd, 2012 with symptoms of palpitations, associated to dizziness and profuse sweating. He denied suffering precordial pain, dyspnea, and other clinical symptoms.
Uncles and cousins with similar symptoms (SIC) however without history of SCD.
Previous pathology history
2007: Syncope and admission ECG: VT with morphology of LBBB.
Previous diagnosis of Ebstein’s Anomaly on September 10th, 2008 Pre-op Echo: dilated RV with low location of the septal leaflet of the tricuspid valve. By surgical description: with no anatomical evidence of Ebstein’s anomaly (finding: significant tricuspid failure with dilated RV)
Correction in December 2008 tricuspid bioprosthesis.
Physical examination at admission
Cardiovascular system: regular heart rhythm, S3 (gallop rhythm), normal heart sounds, no murmur; Respiratory system: vesicular murmur in both hemithoraxes;
Abd: moderate ascites and hepatomegaly (2 cm from right costal margin)
Limbs: palpable peripheral pulses, edema (2+/4+), pitting edema
Apresentaçao do caso
J.P.S.F, 26 anos, natural e procedente de Itatira-CE, solteiro, agricultor
Queixa principal: ̈coração acelerado ̈
Paciente, deu entrada neste serviço no dia 22/07/2012 com quadro de palpitações,associado a vertigem e sudorese profusa.Negava precordialgia, dispnéia e demais queixas clínicas.
Tios e primos com sintomas semelhantes(SIC) porém sem relato de MS
HPP
2007: Síncope e ECG de entrada: TV com morfologia de BRE.
Diagnóstico prévio de Anomalia de Ebstein em 10/09/2008
ECO pré-op: VD dilatado com implantação baixa do folheto septal da VT
Pela descrição cirúrgica: sem evidência anatômica de Anomalia de Ebstein (achado: insuficiência tricúspide importante com VD dilatado)
Correção em Dezembro/2008 Bioprótese tricúspide Exame físico da admissão
ACV:RCR, 3T(Ritmo de galope), BNF, sem sopro; AR:MV + em AHT;
Abd:Ascite moderada e hepatomegalia(2cm do RCD) Ext:PPP, edema(2+/4+), cacifo +
