Hi doctor,
I am 25 years old，male，had PSVT and did an RFA surgery two months back，caught a VT during Holter recently，UCG clear，MRI says left ventricular septum thickening about 20 percent. The local doctor thinks it is a viral myocardity，another doctor that I know says he saw of QRS and he thinks might be ARVC，what is your suggestion? I have high BP sometimes，and now taking Bisoplor and coenzyme q10.
Hello,
Welcome to icliniq.com.
Firstly, the possibility of ARVC (arrhythmogenic right ventricular cardiomyopathy) is less. MRI or echo would pick changes in the right ventricle. I guess right ventricle is normal on echo and MRI so unlikely to be ARVC.
Next thing, you mentioned about thickening of the septum in MRI. What is about your echo finding, does it suggest anything pointing towards hypertrophic cardiomyopathy? So we should rule out hypertrophic cardiomyopathy. If possible, please upload your echo, MRI and routine ECG for interpretation.
Regarding the possibility of viral myocarditis, it would show some changes on echo or MRI so that is also a less likely possibility if echo and MRI not showing any consistent changes. Also, troponin would be positive in active myocarditis. So I would once like to go through your detailed report and see if we can get some clue regarding diagnosis or else we will have to treat it like idiopathic VT (ventricular tachycardia).
For more information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist
Thank you doctor,
I had an ajmaline test and they said unlikely. About UCG, I did four times in past two months，says normal except most recent times the doctor said little bit mitral regurgitation，also about MRI，its just MR. The doctor did not give me radiocontrast agent during exam，that is why he suggested me do twice. Kindly explain.
Hi,
Welcome back to icliniq.com.
Then we should wait for contrast MRI. If it shows some lesion then we may get some idea regarding the cause.
For more information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist
Thank you doctor,
Do I have the f QRS, and epsilon wave, and do I still need to take Bisoprolol and coenzyme Q10?
Hi,
Welcome back to icliniq.com.
Yes, you should continue Bisoprolol and coenzyme Q. Bisoprolol will prevent recurrence of VT and coenzyme for a healthy heart. And f waves are there but a non-specific finding and only one lead has epsilon like wave but not in other leads so not very convincing. Also, no other ECG changes. So overall, ECG is not sufficient to diagnose you as ARVC. We need additional information and contrast MRI may show early changes.
For more information consult a cardiogist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist
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