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首页 ARVC-致心律失常性右室心肌病

ARVC-致心律失常性右室心肌病.doc

ARVC-致心律失常性右室心肌病

李玄明
2019-06-17 0人阅读 举报 0 0 暂无简介

简介:本文档为《ARVC-致心律失常性右室心肌病doc》,可适用于医药卫生领域

TodaywewillseeararecardiomyopathyIt’sArrhythmogenicrightventricularcardiomyopathydysplasia(ARVCD)First,let’sreviewsomeusefulwordsARVCDisararegeneticcardiomyopathycharacterizedbystructuralabnormalitiesoftherightventricleandventriculararrhythmiasInARVCDthereisreplacementofrightventricularmyocardiumwithfattyandfibroustissue,whichleadstoprogressiveRVfailureThemostcommonareaoftissuechangeisthetriangleofdysplasiawhichconsistsoftheinferiorsubtricuspidareaRVapexandtheRVinfundibulumThediseasepresentsbetweenthesecondandfifthdecadesoflifeeitherwithsymptomsofpalpitationsandorsyncopeassociatedwithventriculartachycardiaorwithSCDTheprevalenceofARVCDisrelativelyuncommonbutmayaccountforuptopercentofcasesofsuddendeathamongyoungindividualsandisanimportantcauseofsuddencardiacdeathinyoungathletesThispictureshowsthemostcommonareaoftissuechangeofARVCD,it’sthetriangleofdysplasiawhichconsistsoftheinferiorsubtricuspidareaRVapexandtheRVinfundibulumThediagnosisofARVCDreliesonthedemonstrationofstructural,functional,andelectrophysiologicalabnormalities,andFamilymedicalhistoryTechnicaladvancesinMRIhaveimprovedthecapabilitytoimagetheRVwithreproduciblemeasurementsofvolumeandsystolicfunction,whichpermitsclassificationofseverityanddifferentiationfromnormalityPreviousdiagnosticrelianceonsubjectiveassessmentofRVwallthinning,wallmotionabnormalities,andfattyinfiltrationofthemyocardiumbyMRITherealsohavebeenrecentdevelopmentstoquantifytheextentofRVwallmotionabnormalitiesbyangiographywithcomputerbasedanalysis,aswellastodetermineRVvolumesInaddition,commercialsoftwareisavailabletodetermineRVvolumesandejectionfractionTheRVangiogramobtainedinmultipleviewsisconsideredtobeareliableimagingtesttoassesswallmotionabnormalitiesSoMRIchangeofARVCDincludeFunctionalandMorphologicAbnormalitiesThepicturesshowtheenddiastolicandsystolicframesofashortaxiscineMRIThereisanareaofdyskinesiaintherightventricularfreewallduetoafocalaneurysmThisisaAxialblackbloodimagefromapatientwithARVCD,showingenlargedanddysmorphicolowtractwithfocalbulginganteriorlyThisisaAxialblackbloodimagefromapatientwithARCVDshowinglackofdemarcationbetweenepicardialfatandmyocardiumThisisaFatsuppressedaxialblackbloodimagefromapatientwithARVCDshowingfocalabruptthinningoftheanteriorwalloftheRVAtlastlet’sseeacaseofsuspectofARVCinourdepartmentThisisayearsoldman,withpulmonaryhypertensionyearsECGshowaurialfibrillationandinvertedTwavesThispictureshowtherightventricularenlargementThesetwopicturesshowtherightventricularolowtract(RVOT)widenThispictureshowfattyinfiltrationattheRVapexandtheRVinfundibulumThisfilmshowthereisanareaofdyskinesiaintherightventricularapex

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ARVC-致心律失常性右室心肌病

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