2017, Number 6
Syncope... one more case. Arrhythmogenic cardiomyopathy of the right ventricle
Language: Spanish
References: 16
Page: 565-571
PDF size: 361.30 Kb.
ABSTRACT
Introduction: Syncope is defined as a transitory alteration of the consciousness with spontaneous recovery due to an alteration in general cerebral perfusion and is a very common medical condition in the primary care centers and Emergency. It could be the first manifestation of a cardiac condition (6-30% prevalence), being considered in this situation a bad prognosis marker and high-risk marker of sudden death. Clinical case: Male, 25 years old in the emergency because of syncope. He has had these events three times in the last four months. The patient denies chronic-degenerative diseases and resting EKG shows alteration in repolarization in right precordial electrodes. Discussion: Syncope is a high-prevalence clinical manifestation in the primary care medical centers and ER, the meticulous medical approach in each of the events as the first paraclinical studies are directed toward a cardiac condition as the first differential diagnosis, considering primary electro conduction alteration such as myocardiopathy vs alteration in ion transporting channels which have a genetic origin and have a high risk of sudden death. Conclusions: When following the protocol of one more case of syncope in the ER service, clinical and paraclinical studies conclude a definitive diagnosis of arrhythmogenic myocardiopathy in the right ventricle, showing two mayor and two minor principles of genotypification with a report of plakophilin 2 polymorphism.REFERENCES
Colivicchi F, Ammirati F, Melina D, Guido V, Imperoli G, Santini M; OESIL (Osservatorio Epidemiologico sulla Sincope nel Lazio) Study Investigators. Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: the OESIL risk score. Eur Heart J. 2003; 24 (9): 811-819.
Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC) Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Europace. 2015; 17 (11): 1601-1687.
Task Force for the Diagnosis and Management of Syncope; European Society of Cardiology (ESC); European Heart Rhythm Association (EHRA); Heart Failure Association (HFA); Heart Rhythm Society (HRS), Moya A et al. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J. 2009; 30 (21): 2631-2671.