A 24-year-old man suffered a witnessed cardiac arrest after a padel game. Basic life support was immediately provided. The pre-hospital emergency services team continued the resuscitation efforts, and the patient was accepted for extracorporeal cardiopulmonary resuscitation. The return of spontaneous circulation was achieved in 45 minutes. The initial assessment revealed a ST-segment elevation in leads V4-V6 and a dilated left ventricle with severe systolic dysfunction. Coronary angiography was normal. An improvement in left ventricular systolic function was observed and extracorporeal cardiac support was discontinued after 48 hours. Cardiovascular magnetic resonance imaging demonstrated hypokinesia and subepicardial fatty infiltration of the left ventricle lateral wall. Genetic testing detected a variant of uncertain significance in the ANK2 gene. The diagnosis of arrhythmogenic left ventricular myocardiopathy did not fulfill all the current diagnostic criteria, but it is a very likely diagnosis. An implantable cardioverter-defibrillator was placed. The patient was discharged without physical or cognitive impairment.
Keyphrases
- left ventricular
- cardiopulmonary resuscitation
- cardiac arrest
- mitral valve
- heart failure
- magnetic resonance imaging
- hypertrophic cardiomyopathy
- healthcare
- cardiac resynchronization therapy
- cognitive impairment
- acute myocardial infarction
- left atrial
- case report
- aortic stenosis
- pulmonary artery
- mental health
- pulmonary hypertension
- public health
- quality improvement
- primary care
- physical activity
- emergency department
- early onset
- oxidative stress
- computed tomography
- palliative care
- single cell
- genome wide
- congenital heart disease
- coronary artery
- minimally invasive
- dna methylation
- pulmonary arterial hypertension
- atrial fibrillation
- transcription factor
- fatty acid
- drug induced