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A 45 year old man was admitted because of ventricular tachycardia. He was known to suffer from arrhythmogenic right ventricular cardiomyopathy (ARVC). The rhythmic instability was quickly managed with amiodarone and atenolol. During evaluation of the patient’s cardiomyopathy, echocardiography was performed. Left ventricular global function was normal, but hypokinesia of the basal segment of the lateral wall was observed. The right ventricle was enlarged and appeared hypokinetic, especially at the apex in apical long axis view. The pulmonary infundibulum was enlarged (upper panel). We looked at the tissue Doppler characteristics of the right ventricle, especially the free wall, to quantify regional right ventricular function. We then used tissue Doppler velocity (TVI) curve analysis (lower panel) and observed the disappearance of the base–mid apex velocity gradient, and the presence of an isovolumic relaxation event on the TVI curves of the ARVC patient, contrary to what is seen in normal individuals.
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