A 49-year-old woman with a history of self-limiting recurrent VT referred for CR due to suspected VDD.
No family history of heart disease and normal laboratory tests.
The electrocardiogram at rest (ECG) showed waves is atypical (blacks), T waves (-) from V1 to V4, and prolonged QT (QTc = 510 ms).
The echocardiogram showed a right ventricle with diastolic diameter 30 mm, moderate ventricular dysfunction without segmental alteration, or aneurysm formations.
CR with echo-gradient sequences in 4 lowermost and short axis showed dilation of the right ventricle (RVC 115/cha with lateral walls and severe ventricular dysfunction (LVEF 14%), dyskinetic microaneurysmsms
In addition, fat in the apical LV lateral region (green leaf).
The LV had normal internal volumes and akinetic zone lateral with thinned myocardium (red leaves).
On T1-weighted sequences, fat mass was observed in the subepicardial region of the RV lateral wall and apex, as well as in the LV lateral apical region.
The findings described confirm the diagnosis of RVAD with LV involvement in the presence of two major diagnostic criteria: septal deviation and precordial leads V1 to V4; regional dyskinesia of the RVEF plus telediastolic volume ratio > 40%
The patient's treatment included the implantation of a cardioverter-defibrillator (ICD).
