Arrhythmogenic right ventricular dysplasia: Difference between revisions
No edit summary |
|||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*ARVD is a significant contributor to | *ARVD is a significant contributor to sudden cardiac death in young patients | ||
*More common in males and those of Mediterranean descent | |||
*1:1000-10,000 in the US | |||
*Fibro-fatty replacement of myocardium | |||
==Clinical Features== | |||
*Syncope | |||
*Family history of unexplained syncope or sudden death | |||
*Dysrhythmias refractory to anti-dysrhythmic meds | |||
==Diagnosis== | |||
*Major and minor criteria rely on echo and cardiac MRI | |||
**Echo - hypokinetic and dilated RV, dilation of RVOT | |||
**Cardiac MRI - fibro-fatty change with RV myocardial thinning, RV aneurysms, RV dilatation | |||
*EKG changes and respective sensitivities | |||
**Epsilon wave, 30-50% | |||
**V1-V3 TWI (especially in pts > 14 yoa), 85% | |||
**V1-V3 QRS widening | |||
**Sudden VT episodes with a LBBB morphology | |||
==Management== | |||
*Sotalol is the preferred anti-dysrhythmic | |||
*Manage heart failure in the usual manner | |||
==Disposition== | |||
*Cardiology follow-up for further risk assessment and possible ICD placement or ablation | |||
==Sources== | |||
*Anderson EL. Arrhythmogenic right ventricular dysplasia. Am Fam Physician. 2006 Apr 15;73(8):1391-8. | |||
*Perez Diez D, Brugada J. Diagnosis and Management of Arrhythmogenic Right Ventricular Dysplasia. E-Journal of the ESC Council for Cardiology Practice, European Society of Cardiology 2008. | |||
Revision as of 23:05, 4 January 2016
Background
- ARVD is a significant contributor to sudden cardiac death in young patients
- More common in males and those of Mediterranean descent
- 1:1000-10,000 in the US
- Fibro-fatty replacement of myocardium
Clinical Features
- Syncope
- Family history of unexplained syncope or sudden death
- Dysrhythmias refractory to anti-dysrhythmic meds
Diagnosis
- Major and minor criteria rely on echo and cardiac MRI
- Echo - hypokinetic and dilated RV, dilation of RVOT
- Cardiac MRI - fibro-fatty change with RV myocardial thinning, RV aneurysms, RV dilatation
- EKG changes and respective sensitivities
- Epsilon wave, 30-50%
- V1-V3 TWI (especially in pts > 14 yoa), 85%
- V1-V3 QRS widening
- Sudden VT episodes with a LBBB morphology
Management
- Sotalol is the preferred anti-dysrhythmic
- Manage heart failure in the usual manner
Disposition
- Cardiology follow-up for further risk assessment and possible ICD placement or ablation
Sources
- Anderson EL. Arrhythmogenic right ventricular dysplasia. Am Fam Physician. 2006 Apr 15;73(8):1391-8.
- Perez Diez D, Brugada J. Diagnosis and Management of Arrhythmogenic Right Ventricular Dysplasia. E-Journal of the ESC Council for Cardiology Practice, European Society of Cardiology 2008.