Young patient presenting with cardiogenic shock and refractory ventricular tachycardia: a case of unsuspected arrhythmogenic cardiomyopathy leading to urgent heart transplantation.

IF 1.3 American journal of cardiovascular disease Pub Date : 2024-04-15 eCollection Date: 2024-01-01 DOI:10.62347/TAEY9817
Benoit Yu, Nickolas Poulakos, Alexander Beaulieu-Shearer, Pierre Yves Turgeon, Sylvain Trahan, David Belzile, Mario Sénéchal
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Abstract

Arrhythmogenic right ventricular cardiomyopathy is an important differential diagnosis in young patients presenting with palpitations and/or dyspnea and must be appropriately investigated. A 23-year-old man presented with cardiogenic shock and monomorphic ventricular tachycardia. He reported palpitations and progressive dyspnea for more than two years, but those symptoms were attributed to anxiety without any further investigation by his family physician. Investigations after the catastrophic presentation in our center suggested terminal right-sided heart failure with severe hepatic insufficiency and acute kidney injury. The patient benefited from extracorporeal membrane oxygenation, followed by an urgent heart transplant 16 days later after the exclusion of liver cirrhosis. Histopathologic analysis of the explanted heart confirmed arrhythmogenic cardiomyopathy.

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出现心源性休克和难治性室性心动过速的年轻患者:一例导致紧急心脏移植的未被发现的心律失常性心肌病。
对于出现心悸和/或呼吸困难的年轻患者,致心律失常性右室心肌病是一个重要的鉴别诊断,必须进行适当的检查。一名 23 岁男子出现心源性休克和单形性室性心动过速。他报告心悸和进行性呼吸困难已有两年多时间,但家庭医生将这些症状归因于焦虑,未作进一步检查。在本中心接受灾难性检查后,检查结果显示患者右侧心力衰竭晚期,并伴有严重的肝功能不全和急性肾损伤。患者接受了体外膜肺氧合治疗,16 天后在排除肝硬化的情况下接受了紧急心脏移植手术。移植心脏的组织病理学分析证实了心律失常性心肌病。
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来源期刊
American journal of cardiovascular disease
American journal of cardiovascular disease CARDIAC & CARDIOVASCULAR SYSTEMS-
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