RT Journal Article
SR Electronic
T1 An unusual cause of tachyarrhythmia in an otherwise healthy young man
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1472
OP 1472
DO 10.1136/heartjnl-2017-311485
VO 103
IS 18
A1 Raouf, Wessam A
A1 Shams, Khaled
A1 Mansour, Amr
YR 2017
UL http://heart.bmj.com/content/103/18/1472.abstract
AB Clinical introduction A 32-year-old man referred to the cardiology clinic for palpitations was found to have paroxysmal supraventricular tachycardia (SVT) on 24-hour Holter monitoring. His general and cardiac examinations were unremarkable. A transthoracic echocardiographic study to exclude structural heart disease was performed and showed an abnormal structure in relation to the right ventricular (RV) free wall; however, poor echocardiographic windows precluded proper characterisation. Cardiac MR (CMR) was therefore performed. Cine images (figure 1 and online supplementary videos 1 and 2) demonstrated the abnormal structure. Dynamic pass of contrast (rest perfusion module) showed the sequence of intracavitary enhancement across different cardiac chambers in the horizontal long-axis plane (figure 1 and online supplementary video 3).Figure 1 Still frames from balanced steady state free precession images in the horizontal long-axis plane (A,B). Still frames from the dynamic pass of contrast in the horizontal long-axis and the short axis following contrast injection into the right arm (C,D). Images in the horizontal long-axis plane at the basal level using T2-weighted short-tau inversion recovery (E) and half Fourier single-shot turbo spin echo (F).Supplementary MaterialSupplementary data [cine_shax-ed.mp4] Supplementary MaterialSupplementary data [contrast.avi] Supplementary MaterialSupplementary data [4_chamber.avi] Question The abnormal structure is most likely which of the following?Pericardial cystRight atrial appendage aneurysmRight ventricular aneurysmJuxtaposed left atrial appendageAccessory right ventricular chamberQuestion