A 52-year-old woman with ventricular tachycardia. Issue 24 (4th September 2018)

• Record Type: Journal Article
• Authors: Fidalgo, Ana; Fernandez-Friera, Leticia; Solis, Jorge
• Is Part Of: Heart. Volume 104:Issue 24(2018)
• Page Start: 2025
• Page End: 2043
• Publication Date: 2018-09-04
• Subjects: ventricular tachycardia -- mitral regurgitation; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2018-313347
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Clinical introduction: A 52-year-old woman with shortness of breath and palpitations was referred to a cardiologist. A 24-hour Holter demonstrated high density (37%) of ventricular premature beats (VPBs) and long runs of non-sustained (eventually sustained) monomorphic ventricular tachycardia (VT) with the same morphology as several VPBs detected in a 12-lead ECG (figure 1A ). A transthoracic echocardiogram was performed, and the patient's evaluation was completed with a functional and gadolinium-enhanced cardiovascular MR (CMR) study (figure 1B, C ) to assess structural heart disease. In a follow-up visit, an electrophysiological study (EPS) was performed to identify the origin of VPBs and VT (figure 1D ). Question: What is the most likely cause of VPBs and VT? Idiopathic VT in the absence of structural heart disease. Bileaflet mitral valve prolapse (MVP). Dilated cardiomyopathy. Left ventricular non-compaction cardiomyopathy. Ischaemic cardiomyopathy.