Pediatric Heart Expert Forum
Doctor ruling out ARVD? 16 yrs old
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Doctor ruling out ARVD? 16 yrs old

I'm 16 and last week , I wore a holter monitor for 24 hours and was found to have frequent arrhythmias. He showed me on the ECG/paper where I had the arrhythmias and what I was was a few normal beats( normal sinus rhythm) and then I saw waves that lookes like repeated mountains or upside down W's but  rounded . By this description, was this V-tach? Echo was normal expect for mitral regurgitaion and stress test did not induce arrhythmia ( although I usually get arrhythmias during rest, not WHILE I'm running. ) I didn't tell the doctor that.
Also, while I was sleeping, my heart rate went down to 33. I am not athletic at all and may be considered a couch potato. I'm not overweight, though. I also have idiopathic hypertension.

The doctor now wants an MRI. His working diagnosis is arrhythmogenic w/ dysplasia. Is he referring to arrhythmogenic right ventricular dysplasia? Does the Holter monitor/computer tell them WHERE the arrhythmias came from? For example, left or right ventricle? I mean, why would he want to rule out ARVD?
Tags: arvd
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Dear Disneygurl,

I think that the doctor is indeed looking for arrhythmogenic right ventricular dysplasia/cardiomyopathy (probably was written arrhythmogenic RV dysplasia on the MRI request).  Without evaluating you and your studies, I cannot be sure why specifically ARVD/C would be his working diagnosis.  The ECG can have findings called episilon waves that are associated with this.  As well, if the early beats (I'm presuming premature ventricular contractions) were captured on the ECG, it can tell you from where they are arising.  However, the Holter monitor does not tell you from where the beats are coming; it only tells you if they are coming from multiple locations and how many there are.  Also, an echo can miss the RV findings of ARVD/C, which is why an MRI is helpful.

Of note, ARVD/C is very uncommon in the US, but is much more common in patients from the Veneto region of Italy.  
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