1例酷似急性心肌炎的致心律失常性右室心肌病/发育不良

摘要

致心律失常性右室心肌病/发育不良是一种右室心肌被纤维脂肪组织进行性替代的心脏病.本病例为青年女性,因反复心悸7d,加重伴腹泻1d入院.入院时辅助检查提示:室性心律失常伴心肌损伤指标增高,考虑为急性重症心肌炎.随后的诊治发现,心电图提示:窦性心律,可见Epsi1on波,心脏影像学检查提示右心增大,右心室内低密度脂肪影,而左心形态功能正常.出院时诊断为致心律失常性右室心肌病.该病例提示对右心增大、心肌受损合并室速的病人应进行多病因的思考.%Arrhythmogenic right ventricular cardiomyopathy/dysplasia is a heart disease in which right ventricular myocardium is replaced by fibrous adipose tissue.This paper reports a case of young female patient who was hospitalized for palpitation 7 days,diarrhea 1 d.The electrocardiogram results of the woman showed that ventricular tachycardia and myocardial injury index in plasma was increased.The diagnosis made on admission was acute severe myocarditis.Then,we found that electrocardiogram indicated that electrocardiogram indicated Epsilon wave can be seen in chest leads.Cardiac imaging revealed enlarged right heart and low density fat shadow in the right ventricle,while left ventricular shape and function were normal.At the time of discharge,the patient was diagnosed with arrhythmogenic right ventricular cardiomyopathy.This case suggests that we should have multiple etiological considerations for right ventricular enlargement,myocardial damage,and ventricular tachycardia.