Arrhythmogenic Right Ventricular Cardiomyopathy with Sustained Ventricular Tachycardia: A Case Report

Introduction: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare genetic disorder characterized by fibrofatty replacement of the right ventricular myocardium, which predisposes individuals to life-threatening arrhythmias. We present a case of an ARVC patient who experienced recurrent episodes of sustained ventricular tachycardia (VT). In this case, we mainly discuss the application of myocardial contrast echocardiography (MCE) in displaying myocardial fibrosis in ARVC. Case presentation: A 43-year-old male experienced three unexplained ventricular tachycardias within an eight-year period, accompanied by symptoms of chest discomfort, palpitations and dizziness. Coronary angiography revealed no significant coronary stenosis. The electrocardiogram (ECG) results indicated characteristic epsilon waves in right precordial leads, and subsequent echocardiography revealed right ventricular enlargement and right ventricular systolic dysfunction. MCE identified regional myocardial ischemia at the epicardium of left ventricular apex. Finally, cardiovascular magnetic resonance imaging (CMR) confirmed the presence of ARVC based on the linear intensification observed in the RV during the delayed enhancement. Conclusion To make sure timely intervention and management, early recognition is of paramount importance. MCE may offer an effective and valuable technique for the detection of myocardial involvement in ARVC patient.