Presentation
Because of the progressive nature of the disorder, patients may present with any number of symptoms. [af-ablation.org]
Unfortunately, SCA may also be the presenting symptom; patients with no prior symptoms may present with SCA. [geneticheartdisease.org]
Presentation usually occurs in the neonatal and childhood years with clinical aspects of congestive heart failure. [radiopaedia.org]
Our case presentation is interesting for 2 reasons: first, because of its rare presentation and second, because of the patient's history of life-threatening arrhythmias. [revespcardiol.org]
The topics discussed are relevant to chest physicians, thoracic surgeons, nurses, students, and teachers, and a well-balanced mix of contributions ensures that doctors, clinicians, and institutions from all around the world will find the information presented [books.google.de]
Cardiovascular
- Heart Disease
ICD-10-CM Codes › I00-I99 Diseases of the circulatory system › I30-I52 Other forms of heart disease › I51- Complications and ill-defined descriptions of heart disease › Heart disease, unspecified 2016 2017 2018 2019 Billable/Specific Code I51.9 is a billable [icd10data.com]
Treatments include: We treat a full range of hereditary heart and blood vessel diseases: Clinical trials for inherited heart disease often test new medications. [familyheart.stanford.edu]
Double outlet right ventricle (DORV) is a heart disease that is present from birth (congenital). [medlineplus.gov]
The right ventricle in congenital heart disease. Heart. 2006;92(Suppl1):i27–38. PubMedCentral PubMed CrossRef Google Scholar 4. Haddad F, Hunt SA, Rosenthal DN, Murphy J. Right ventricular function in cardiovascular disease. [link.springer.com]
Sudden death is the first manifestation of the disease in 11% to 22% of patients. 1 We present the case of a 58-year-old man, with no personal or family history of heart disease, who was admitted to our hospital with a 1-month history of dyspnea. [revespcardiol.org]
- Palpitations
Symptoms of ARVC The most common symptom is palpitations. Palpitations can occur at rest but are often triggered by physical activity. They may be associated with chest pain, light-headedness or blackouts. [c-r-y.org.uk]
The palpitations may be intermittent or may require medical intervention to resolve. [medicinenet.com]
Method: CMRI of a young Asian female who presented with palpitations and history of sudden death in the family, imaged by a 3.0 Tesla MRI scanner with a maximum gradient strength of 33mT/m and a 16 element phased-array coil with electrocardiography gating [omicsonline.org]
There are many different causes within these categories including: Heart palpitations, shortness of breath, and chest pain may be symptoms of RVH. [medicalnewstoday.com]
Unexplained dizzy spells, sustained palpitations, or blackouts can be signs of a hot phase. If you experience any of these symptoms, you should see your doctor immediately. [bhf.org.uk]
Skin
- Keratosis
DSG2 125671 Arrhythmogenic right ventricular dysplasia 10; dilated cardiomyopathy AD 12 DSP 125647 dilated cardiomyopathy with woolly hair and keratoderma; arrhythmogenic right ventricular dysplasia type 8; lethal acantholytic epidermolysis bullosa; Keratosis [centogene.com]
Differential Diagnosis of ARVD Anatomic Atrial septal defect Biventricular dysplasia Isolated myocarditis Naxos disease (ARVD associated with palmoplantar keratosis) Right ventricular infarct Right-sided valve insufficiency Uhl’s anomaly (congenital absence [af-ablation.org]
AVRD/DC Family history (clinical diagnosis based on present criteria) View/Print Table TABLE 3 Differential Diagnosis of ARVD Anatomic Atrial septal defect Biventricular dysplasia Isolated myocarditis Naxos disease (ARVD associated with palmoplantar keratosis [aafp.org]
[…] cardiomyopathy 3 Nemaline myopathy 1 Titin Hypertrophic cardiomyopathy 9 Other Fibrillin Marfan syndrome Weill–Marchesani syndrome Filamin FG syndrome 2 Boomerang dysplasia Larsen syndrome Terminal osseous dysplasia with pigmentary defects IF 1/2 Keratinopathy ( keratosis [en.wikipedia.org]
- Palmoplantar Keratosis
Differential Diagnosis of ARVD Anatomic Atrial septal defect Biventricular dysplasia Isolated myocarditis Naxos disease (ARVD associated with palmoplantar keratosis) Right ventricular infarct Right-sided valve insufficiency Uhl’s anomaly (congenital absence [af-ablation.org]
Ischemic heart disease VT Right ventricular outflow tract VT Supraventricular tachycardia TABLE 3 Differential Diagnosis of ARVD Anatomic Atrial septal defect Biventricular dysplasia Isolated myocarditis Naxos disease (ARVD associated with palmoplantar [aafp.org]
Musculoskeletal
- Myopathy
RESULTS The myopathy, which is most frequently… CONTINUE READING [semanticscholar.org]
[…] with early respiratory failure; dilated cardiomyopathy type 1G; limb-girdle muscular dystrophy type 2J; early-onset myopathy with fatal cardiomyopathy; familial hypertrophic cardiomyopathy type 9 AD, AR 101 Abbreviations: LQT: Long QT syndrome; CPVT: [centogene.com]
3 Myosin Elejalde syndrome Hypertrophic cardiomyopathy 1, 8, 10 Usher syndrome 1B Freeman–Sheldon syndrome DFN A3, 4, 11, 17, 22; B2, 30, 37, 48 May–Hegglin anomaly Troponin Hypertrophic cardiomyopathy 7, 2 Nemaline myopathy 4, 5 Tropomyosin Hypertrophic [en.wikipedia.org]
- Myalgia
This point is usually marked by the development of hypotension or other dose-limiting side effects such as headache, nausea/vomiting, diarrhea, myalgias, arthralgias, and trismus. [phaonlineuniv.org]
Neurologic
- Confusion
You’re confused and forget things. How Is it Treated? There is no cure for heart failure, but there are treatments for its symptoms. Talk to your doctor. She may suggest medications to make you more comfortable. [webmd.com]
Palpitations, fatigue, and syncope appear to be the most common symptoms, but patients may have other nonspecific complaints such as abdominal pain and mental confusion. [af-ablation.org]
Palpitations, fatigue, and syncope appear to be the most common symptoms, but patients may have other nonspecific complaints such as abdominal pain and mental confusion ( Table 1 ). [aafp.org]
Patients with severe LV failure may appear visibly dyspneic or cyanotic, hypotensive, and confused or agitated because of hypoxia and poor cerebral perfusion. Some of these less specific symptoms (eg, confusion) are more common in the elderly. [merckmanuals.com]
- Akinesia
Major clinical features and signs identified in ARVD/ARVC affected patients include right ventricular akinesia, dyskinesia or aneurism accompanied with abnormal sizes of parasternal long and short axes and changes in end-systolic volume and right ventricular [centogene.com]
Workup
These measurements could be included as part of the routine workup in all end-stage renal disease patients on hemodialysis. © 2016 S. [karger.com]
QT, RR, ST Intervals
- ST Elevation
Engstrom AE, Vis MM, Bouma BJ, van den Brink RB, Baan J Jr, Claessen BE, Kikkert WJ, Sjauw KD, Meuwissen M, Koch KT, de Winter RJ, Tijssen JG, Piek JJ, Henriques JP: Right ventricular dysfunction is an independent predictor for mortality in ST-elevation [karger.com]
Blocks
- Right Bundle Branch Block
Fig. 19.5.A Right bundle-branch block. Left bundle-branch block The situation in left bundle-branch block (LBBB) is similar, but activation proceeds in a direction opposite to RBBB. [bem.fi]
[…] coronary cusp 右脚ブロック right bundle branch block (RBBB) 右胸心 dextrocardia, dextroposition of heart, dextroversion of heart 右軸偏位 right axis deviation (RAD) 右室異形成[症] right ventricular (ventricle) dysplasia, dysplasia of right ventricle 右室依存性冠循環 right ventricle-dependent [j-circ.or.jp]
A: Electrocardiogram showing sinus rhythm with second-degree atrioventricular block Mobitz I, epsilon wave, inverted T waves from V1 to V4, and isolated ventricular ectopic beats with complete left bundle branch block. [revespcardiol.org]
These findings include T-wave inversion in the anterior precordial leads (V1 through V6), epsilon waves, or VT with a left bundle branch block pattern, although polymorphic and right bundle branch block patterns also have been reported. [af-ablation.org]
Significance of electrocardiographic right bundle branch block in trained athletes. Am J Cardiol 2011;107:1083-9. Wasfy MM, DeLuca J, Wang F, et al. [acc.org]
T Wave
- T Wave Inversion
Electrocardiographic Features ARVD is associated with characteristic ECG abnormalities: Epsilon wave (most specific finding, seen in 30% of patients) T wave inversion in V1-3 (85% of patients) Prolonged S-wave upstroke of 55ms in V1-3 (95% of patients [lifeinthefastlane.com]
ECG T-wave inversion in right precordial leads (V 2 and V 3 ) 2. SAECG Late potentials seen on signal-averaged ECG 3. Arrhythmia LBBB type VT on ECG, Holter monitoring or during exercise testing Extrasystoles >200 over a 24-h period * 4. [geneticheartdisease.org]
Prevalence of T-wave inversion beyond V1 in young normal individuals and usefulness for the diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia. Am J Cardiol 2005; 95(9): 1070-1. [ Links ] 17. Basso C, Corrado D, Thiene G. [scielo.edu.uy]
These findings include T-wave inversion in the anterior precordial leads (V1 through V6), epsilon waves, or VT with a left bundle branch block pattern, although polymorphic and right bundle branch block patterns also have been reported. [af-ablation.org]
T-wave inversion in the septal leads, incomplete and complete right-bundle branch block, and ECG criteria for RV hypertrophy are all more common in athletes, particularly endurance trained athletes. 5-7 Finally, RV functional remodelling is also prominent [acc.org]
Treatment
In an emergency, treatment for ventricular tachycardia may include: CPR electrical defibrillation electric shock antiarrhythmic medication Long-term treatment may include oral antiarrhythmic medication. [healthline.com]
Virology: Research and Treatment about the journal submit your research Indexing: DOAJ, EBSCO, PubMed Central (PMC) and more. [insights.sagepub.com]
Management and treatment In the presence of two viable ventricles, biventricular repair is the optimal treatment for DORV and it is quite safely achieved in the simple forms (DORV-VSD type, DORV-Fallot type and DORV-TGA type). [orpha.net]
Prognosis
Prognosis Without treatment, prognosis is poor due to severe cyanosis, congestive heart failure or pulmonary hypertension. With biventricular repair, patients have, on average, a normal life expectancy. [orpha.net]
Prognosis Prognosis depends strongly on the underlying cause of the acute right heart syndrome. In pulmonary embolism, prognosis is quite good if the patient can be stabilized hemodynamically, but very poor (> 50% mortality) if not. [clinicaladvisor.com]
The overall prognosis in ARVD is not clear. [geneticheartdisease.org]
However, individuals with a family history of ARVC may benefit from genetic testing and counseling before planning for a baby The prognosis for Arrhythmogenic Right Ventricular Cardiomyopathy is favorable, if the condition is diagnosed early and treated [dovemed.com]
PAH is associated with a poor prognosis. [phaonlineuniv.org]
Etiology
Humphrey Abstract We report a case of transient right ventricular dysfunction associated with prolonged cardiac tamponade, an unusual complication of uncertain etiology. [ajol.info]
In the remaining cases, it is believed to be due to an acquired etiology (e.g. virus infection) or to unidentified inheritance. The genes identified to date include the ryanodine receptor 2 (RYR2) and desmoplakin. [bcm.edu]
Etiology DORV results from an error in formation of the cono-truncus, which is the primary outlet of the heart during embryonic development. The cono-truncal anomalies result in neural crest and second heart field dysfunction. [orpha.net]
Acute lung edema was diagnosed in 19 (7.3 %) patients and ischemic etiology as the cause of heart failure was discovered in 198 (76.5 %) patients. [cardiovascularultrasound.biomedcentral.com]
(Etiology) Arrhythmogenic Right Ventricular Cardiomyopathy is caused by mutations in at least 5 genes involved in the formation and function of desmosomes. [dovemed.com]
Epidemiology
Summary Epidemiology DORV accounts for about 2-3% of all congenital heart defects, with a birth prevalence rate of 1/ 10,000 neonates as reported in Germany. [orpha.net]
House AA: Cardio-renal syndrome type 4: epidemiology, pathophysiology and treatment. Semin Nephrol 2012;32:40-48. [karger.com]
Epidemiology The incidence of acute cor pulmonale depends on the underlying cause. [clinicaladvisor.com]
Epidemiology of heart failure: The prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review. European Journal of Heart Failure, 18(3), 242-252. Von Bibra, H., Ströhle, A., St. [oiiq.org]
Epidemiology [ edit ] The prevalence of ARVD is about 1/10,000 in the general population in the United States, although some studies have suggested that it may be as common as 1/1,000. [en.wikipedia.org]
Pathophysiology
Can J Anaesth: 2012, 59(6);586-603 [PubMed:22528163] [WorldCat.org] [DOI] (I p) François Haddad, Ramona Doyle, Daniel J Murphy, Sharon A Hunt Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management [openanesthesia.org]
“Acute right ventricular failure — from pathophysiology to new treatments”. Intensive Care Med. vol. 30. 2004. pp. 185 Thorough review of all aspects of acute cor pulmonale, with an emphasis on pathophysiology and diagnosis. [clinicaladvisor.com]
Right ventricular contractile reserve and pulmonary circulation uncoupling during exercise challenge in heart failure: pathophysiology and clinical phenotypes. JACC Heart Fail. 2016. doi:10.1016/j.jchf.2016.03.007. [thecardiologyadvisor.com]
Pathophysiology Regardless of the mode of inheritance, it appears that the mutant genes code for similar proteins. The mutant proteins are called desmosomes. [geneticheartdisease.org]
Part II pathophysiology, clinical importance and management of right ventricular failure. Circulation. 2008;117:1717–31. PubMed CrossRef Google Scholar 6. Farb A, Burke AP, Virmani R. [link.springer.com]
Prevention
Infants who receive a heart transplant will need to take medicines for the rest of their lives to prevent their body from rejecting the new heart. References Parker SE, Mai CT, Canfield MA, et al; for the National Birth Defects Prevention Network. [cdc.gov]
The treatment of ARVD is focused on controlling abnormal heart rhythms, preventing sudden death, and managing any symptoms of heart failure that may be present. [brighamandwomens.org]
Endocarditis Prevention Antibiotics to prevent endocarditis are needed before certain dental procedures. See the section on Endocarditis for more information. [heart.org]
Preventing right ventricular hypertrophy from getting worse is possible in many cases. Prevention methods for RVH include reducing individual risk factors and promoting a heart and lung-healthy lifestyle. [medicalnewstoday.com]
The goal of treatment is to correct the heart rhythm immediately and to prevent future episodes. [healthline.com]