A 59-year-old woman was admitted to the hospital with unheralded syncope. She had lost a son to sudden cardiac death when he was 29 years of age. On hospital day 2, the patient developed sustained monomorphic ventricular tachycardia treated with synchronized cardioversion and intravenous amiodarone. An electrocardiogram was performed after the event (Panel A). A transesophageal echocardiogram showed a severely dilated right ventricle (Panel B). Cardiac magnetic resonance imaging showed a right ventricular ejection fraction of 27% with regional akinesis.
What is the most likely diagnosis?
A. Arrhythmogenic right ventricular cardiomyopathy
B. Brugada Syndrome
C. Cardiac sarcoidosis
D. Inferior Myocardial Infarction
E. Pulmonary Embolism
答案解析:
诊断为致心律失常性右心室心肌病(ARVC)。ECG 显示 epsilon 波(QRS 波群返回等电位线后出现的离散小振幅电位),这是诊断这种疾病的主要诊断标准。放置了植入式心脏复律除颤器,并开始使用美托洛尔和抗心律失常药物进行治疗。
正确答案:A
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