Case 2/2019 - Man with Arrhythmogenic Cardiopathy Followed by Rapidly Progressive Heart Failure

Figures

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  Figure 1. Left ventricular outflow tract: bivalve aortic valve, showing thickened semilunar leaflets (*), with moderate retraction at the free border, suggestive of valvular regurgitation. The anterior descending (ADA) and circumflex (Cx) coronary arteries originate from separate ostia, in the left Valsalva sinus; the ADA ostium lies posterior to the Cx ostium and is tangential. The right coronary artery (RCA) ostium is located in the right Valsalva sinus.

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  Figure 2. Left lateral surface of the base of the heart: A) Crossing (arrow) of the proximal epicardial segments of the anterior descending artery (ADA) and circumflex (Cx) artery; the ADA is in a position above the Cx. B) Cx course from its origin at the aorta (AO). The ADA has been folded superiorly to show the circumflex artery epicardial course. LM: left marginal branch of the Cx. PT: pulmonary trunk.

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  Figure 3. Sternocostal surface of the heart: intramyocardial course (arrows) of the anterior descending artery (ADA). D1- First diagonal branch of the ADA. PT: pulmonary trunk.

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  Figure 4. Photomicrography of the left ventricular myocardium: Diffuse myocardial fibrosis (in blue). Masson’s trichrome, 50x).