PMC3120278_01
(a) 12-lead ECG recording of VT with left bundle branch block morphology. (b) 12-lead ECG with inverted T-waves and postexcitation epsilon wave in leads V1 to V4
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F1
Rest electrocardiogram displayed atrial fibrillation rhythm, epsilon wave, and negative T-waves in leads V1 to V4 [Figure 1].
Echocardiography image in the parasternal long axis showing severe dilation of the right ventricle and severe tricuspid valve regurgitation
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F2
It could be found from the echocardiography that there was severe dilation of the right ventricle, with a poor right ventricular (RV) systolic function and severe tricuspid valve regurgitation and decreased left ventricular ejection fraction [Figure 2].
MRI showing the dilation of RV and transmural fibrofatty replacement in the RV free wall
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F3
ARVC was most likely, the patient underwent a magnetic resonance imaging scan which revealed diffuse areas of fat tissue at the right ventricular wall especially at the free wall [Figure 3]. At the same time, multiple small aneurysms were also found.
(a) A gross photograph demonstrating the right ventricular with extensive fatty replacement primarily involving the lateral wall. (b) Typical histologic features of ARVC, ongoing myocyte death with early fibrosis and adipocyte infiltration
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F4
The general and cardiac biopsy findings demonstrated diagnosis was consistent with ARVC [Figure 4].