Rapid progression of right ventricular dysfunction: a case report

Figures

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  Fig. 1. ECG results before 4-month, revealing a typical manifestation of an advanced form of biventricular arrhythmogenic cardiomyopathy (25 mm/s 10 mm/mV) ECG: electrocardiogram

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  Fig. 2. Echocardiography showed major dilatation of the right ventricle and atrium associated with regional wall motion abnormalities. Parasternal long-axis right ventricular outflow tract at end diastole: 60 mm; tricuspid annular plane systolic excursion: 8 mm; tricuspid regurgitation area: 10cm2; left ventricle ejection fraction: 52%

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  Fig. 3. Delayed phase imaging of CMR indicated the presence of myocardial fibrosis in right ventricle. Fatty infiltration of the free wall of the left ventricle may be present CMR: cardiac magnetic resonance Right ventricle: ejection fraction, 16.7%; end-diastolic volume: 286 mL; end-systolic volume: 238 mL; stroke volume: 48 mL Left ventricle: ejection fraction: 52%; end-diastolic volume: 79 mL; end-systolic volume: 37 mL; stroke volume: 42 mL

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  Fig. 4. Masson’s trichrome staining (A) and HE staining (B) of RV showed typical presence of ACM (both magnification 2×). The black box was amplified (C, magnification 40×), indicating multiple foci of lymphocytic infiltration. RV: right ventricle, ACM: arrhythmogenic cardiomyopathy

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  Fig. 5. Immunohistochemistry CD3 (A) and CD8 (B) staining results (both magnification 10×) of RV.

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  Fig. 6. Masson’s trichrome staining (A) and HE staining (B) of LV (both magnification 2×)