rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2024-3005OVXPMHrpcardio-3005Research ArticleCLINICAL CASEКЛИНИЧЕСКИЙ СЛУЧАЙAcute myocardial infarction-like event in a young patient with biventricular arrhythmogenic cardiomyopathyБивентрикулярная аритмогенная кардиомиопатия под маской инфаркта миокарда у пациента молодого возрастаhttps://orcid.org/0000-0001-9323-4444СтавцеваЮ. В.StavtsevaY. V.

Ставцева Юлия Вадимовна 

Москва

Yulia V. Stavtseva

Moscow

y.stavtseva@gmail.comhttps://orcid.org/0000-0002-1266-4926МершинаЕ. А.MershinaE. A.

Мершина Елена Александровна 

Москва

Elena A. Mershina

Moscow

elena_mershina@mail.ruhttps://orcid.org/0000-0002-3461-9632ЛобжанидзеТ. В..LobzhanidzeT. V.

Лобжанидзе Тинатин Викторовна 

Москва

Tinatin V. Lobzhanidze

Moscow

tinatin77@mail.ruhttps://orcid.org/0000-0002-5937-3042БаздыреваЕ. И.BazdirevaE. I.

Баздырева Елена Ивановна 

Москва

Elena I. Bazdyreva

Moscow

elenabaz@615gmail.comhttps://orcid.org/0009-0009-2669-8092ХуцишвилиН. И.KhutsishviliN. I.

Хуцишвили Нуцико Ивановна

Москва

Nutsiko I. Khutsishvili

Moscow

nutsiko.khutsishvili@gmail.comhttps://orcid.org/0000-0002-5873-1768КобалаваЖ. Д.KobalavaZh. D.

Кобалава Жанна Давидовна 

Москва

Zhanna D. Kobalava

Moscow

zkobalava@mail.ruРоссийский университет дружбы народов имени Патриса ЛумумбыРоссияRUDN UniversityRussian FederationМосковский государственный университет имени М.В. ЛомоносоваРоссияLomonosov Moscow State UniversityRussian Federation2024210220242015762Copyright © Stavtseva Y.V., Mershina E.A., Lobzhanidze T.V., Bazdireva E.I., Khutsishvili N.I., Kobalava Z.D., 20242024Ставцева Ю.В., Мершина Е.А., Лобжанидзе Т.В., Баздырева Е.И., Хуцишвили Н.И., Кобалава Ж.Д.Stavtseva Y.V., Mershina E.A., Lobzhanidze T.V., Bazdireva E.I., Khutsishvili N.I., Kobalava Z.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/3005

The article describes a clinical case of biventricular arrhythmogenic cardiomyopathy (ACM) presented with myocardial infarction (MI) — like event in a young patient. The patient was hospitalized with suspected acute coronary syndrome and an episode of ventricular tachycardia (VT). Based on increased cardiac troponin, left ventricular systolic dysfunction with wall motion abnormalities, and nonobstructive coronary arteries the initial diagnosis of type 2 MI was made. To verify the etiology behind VT and ventricular structural abnormalities cardiac magnetic resonance imaging (MRI) was performed. Abnormalities of both right and left ventricles demonstrated by MRI and supported by the genetic testing established the diagnosis of biventricular ACM. Since the diagnosis was made, initially diagnosed MI was reassessed in favor of acute myocardial injury as a characteristic of ACM course. ACM should be included into differential diagnosis with MI and acute myocarditis in patients with elevated troponin and nonobstructive coronary arteries.

В статье представлено описание клинического наблюдения пациента молодого возраста с ранее недиагностированной бивентрикулярной аритмогенной кардиомиопатией (АКМП), госпитализированного с подозрением на острый коронарный синдром на фоне эпизода желудочковой тахикардии (ЖТ). На основании клинической картины, повышения тропонина I и наличия зон нарушения локальной сократимости левого желудочка с нарушением его систолической функции при отсутствии значимого атеросклеротического поражения коронарных артерий по данным коронарографии, первоначально был диагностирован инфаркт миокарда (ИМ) 2 типа. Для уточнения генеза ЖТ и характера поражения желудочков пациенту была проведена магнитно-резонансная томография (МРТ). Выявленные при МРТ аномалии правого и левого желудочков, а также результаты генетического исследования позволили верифицировать бивентрикулярную АКМП. Постановка данного диагноза заставила пересмотреть верифицированный ранее ИМ 2 типа в пользу острого повреждения миокарда в рамках патогенеза АКМП. АКМП следует включать в спектр заболеваний для дифференциального диагноза при подозрении на острый миокардит или ИМ у пациентов с повышением тропонина и без значимой обструкции коронарных артерий.

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The authors declare that there are no conflicts of interest present.