Myocarditic appearance of arrhythmogenic right ventricular cardiomyopathy.

A 48-year-old man presented with syncope due to tachycardia of left ventricular origin and was electrically cardioverted to sinus rhythm. There was no medical history of cardiac disease or family history of sudden cardiac death. Resting electrocardiography displayed epsilon waves (Figure, A). Coronary angiography revealed unobstructed arteries. Transthoracic echocardiography (Movies I and II) showed normal left ventricular dimensions with mild systolic dysfunction. The right ventricle was mildly dilated, with reduced systolic function but no regional wall-motion abnormalities or aneurysms. The right ventricular outflow tract measured 41 mm. Figure. A, Epsilon waves. B, Short-axis image at midventricular level. Late enhancement of the right ventricular border of the septum is seen, extending into epicardium of the anterior and inferior …