Myocarditis as a risk factor for the development of arrhythmogenic cardiomyopathy

Abstract

Introduction: Ventricular arrhythmias and a high risk of sudden cardiac death are features of arrhythmogenic cardiomyopathy (ACM), a progressive myocardial disease with a genetic or acquired etiology. This case report aims to highlight the significance of cardiac magnetic resonance imaging (MRI) in diagnosis, as well as its diagnostic and treatment aspects in arrhythmogenic cardiomyopathy. Methods: We describe a clinical case of a female patient who had a distant history of myocarditis. The patient had ventricular tachycardia that progressed to ventricular fibrillation and recurrent syncope. For risk assessment and diagnostic confirmation, extensive clinical and instrumental investigations were carried out, including cardiac magnetic resonance imaging and echocardiography. Results: Arrhythmogenic cardiomyopathy was diagnosed based on the examinations, which showed biventricular dilatation and myocardial fibrosis. To prevent sudden cardiac death, the patient received an implanted cardioverter-defibrillator (ICD) after undergoing successful defibrillation. Conclusion: This case highlights the importance of cardiac magnetic resonance imaging in diagnosing arrhythmogenic cardiomyopathy, particularly when the cause is not genetic. The prognosis of patients is improved, and the risk of sudden cardiac death is considerably decreased with early risk stratification and device-based therapy.