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Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a cardiomyopathy that manifests with ventricular tachycardia (VT), ventricular fibrillation (VF) and sudden cardiac death (SCD). Hence immediate intervention is necessary for this type of presentation. A 67-year-old man was admitted to our emergency department with palpitation. Electrocardiogram (ECG) showed VT. Despite amiodarone and lidocaine administration VT persisted. After the cardioversion (CV) the rhythm became sinus and in the right precordial leads inverted T waves were present. Transthoracic echocardiography (TTE) showed two large aneurysms divided by a septum in the right ventricle (RV). Cardiac magnetic resonance imaging (CMR) also revealed two aneurysms and a dyskinetic segment in the RV. In the intensive care unit, patient was treated with amiodarone (400 mg/daily). In the meantime, the patient had an advanced lung cancer that extended to the pleura and pulmonary artery. Implantable cardiac defibrillator (ICD) was not implanted because the predicted survival was under six months and also the patient refused any invasive treatment including VT ablation. Therefore, we discharged patient with metoprolol (100 mg/daily) and amiodarone (400 mg/daily). In the follow-up period, no VT attacks occurred. After three years of the first diagnosis, patient woke up with a sense of palpitation and then died suddenly. In this case, double chamber RV due to ARVD and the therapy guidance were discussed.

An Underdiagnosed ARVC Case until the Age of 67-Years with Two Large Aneurysms in the Right Ventricle