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March 21, 2026European Journal of Preventive Cardiology

PO64 Sudden Death: 10-Year Search for the Underlying Cause

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Population

One 24-year-old man referred after his mother's sudden death

Design

Case report

Follow-up

10 years

Key result

Genetic re-evaluation of a patient with arrhythmogenic cardiomyopathy identified a pathogenic DSP deletion, correcting a 10-year misdiagnosis of a PKP2 variant and altering family screening.

Authors

EMEmídio MataBGBárbara Lage GarciaTPTamara N. Pereira

Discussion

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Overview

Re-evaluate ACM genetic variants periodically; extends evidence that reclassification can correct misdiagnoses and alter family screening.

Key Points

  • The study aims to clarify the genetic causes of sudden death in a young man with arrhythmogenic cardiomyopathy.
  • Genetic analysis of PKP2 and DSP genes
  • Cardiac imaging using MRI to assess heart function
  • Holter monitoring to evaluate arrhythmias
  • Clinical assessment including echocardiography
  • Initial identification of pathogenic and uncertain genetic variants in PKP2 and DSP genes
  • Progression of LV dysfunction from EF 48% to 38%; subsequent improvement to EF 56% after treatment
  • Discovery of a likely pathogenic DSP gene variant affecting cardiac function
  • In silico classification of PKP2 gene variant as uncertain highlights need for thorough genetic evaluation.

Structured PICO

P
Population
1 patient, a 24-year-old man with a family history of sudden death, initially diagnosed with arrhythmogenic cardiomyopathy (ACM) and later re-diagnosed with non-dilated cardiomyopathy with biventricular involvement.
I
Intervention
Re-evaluation with updated genetic testing and cardiac magnetic resonance imaging (CMR)

This case highlights the critical importance of periodically re-evaluating genetic variants and integrating them with clinical imaging, as a patient's diagnosis was fundamentally changed 10 years later, impacting both his management and family screening.

Cite This Study

Mata et al. (2026) studied this question. Genetic re-evaluation of a patient with arrhythmogenic cardiomyopathy identified a pathogenic DSP deletion, correcting a 10-year misdiagnosis of a PKP2 variant and altering family screening.

synapsesocial.com/papers/69be38b56e48c4981c6794cdhttps://doi.org/10.1093/eurjpc/zwag115.063
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