A 22-year-old male who came to the Primary Care (PC) clinic with a history of functional murmur in childhood, seasonal allergic rinitis, 10-week-old smoker and drink.
Family history was uninterested.
After performing an ECG in the Primary Care consultation required prior to travel abroad to study in a private university in the United Kingdom, a generalized negative T wave from V2 to V6 and isolated ventricular extrasystoles was observed.
Physical examination showed blood pressure levels of 140/70 mm Hg, normal cardiopulmonary auscultation at 60 beats per minute with no other relevant data.
With these electrophysiological findings, she was referred to the Cardiology consultation.
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Pathologic studies requested from PC are normal (analytical with complete blood count, biochemistry and coagulation; lateral chest x-ray and anticoagulant).
The echocardiogram detected a significant dilatation of the right ventricle (55 mm), with hypokinetic lateral face as well as mild tricuspid insufficiency.
Holter monitoring showed sinus rhythm and migratory atrial fibrillation with frequent ventricular extrasystole and some ventricular triplet.
The cardiac MRI shows a right ventricle with increased size and hypertrophy of the moderating band with walls with some hyperintense areas inside suggestive of fat infiltrating, with small dyskinetic sacculations.
The left ventricle, valves and pericardium are normal.
With the suspected diagnosis of AVD, treatment with beta-blockers was established.
The asymptomatic patient followed periodic controls.
After returning to Spain two years later, after playing a basketball game, he developed a syncopal picture, so it was finally decided to implement an ICD.
One month after admission, the patient was referred to the Rehabilitation Service to assess the start of a Cardiac Rehabilitation Program (CPR).
The patient is currently an active life, one year later, with follow-up from Primary Care and revisions by Cardiology.
