Patient's Query
Hi doctor,
I am a 25-year-old male. I had PSVT (paroxysmal supraventricular tachycardia) and underwent RFA (radiofrequency ablation) surgery two months ago, and I experienced a VT (ventricular tachycardia) during a Holter monitor test. Recently, I had an ECG, which was clear, but an MRI showed that the left ventricular septum is thickened by about 20 percent. The local doctor believes it is viral myocarditis, while another doctor I know noted the QRS changes and thinks it might be ARVC (arrhythmogenic right ventricular cardiomyopathy).
What is your suggestion? I occasionally have high blood pressure and am currently taking Bisoprolol and Coenzyme Q10.
Hi,
Welcome to icliniq.com.
Firstly, the possibility of ARVC (arrhythmogenic right ventricular cardiomyopathy) is low. An MRI or echocardiogram would detect changes in the right ventricle, and I believe your right ventricle is normal on both the echo and MRI (magnetic resonance imaging), making ARVC unlikely.
Next, you mentioned the thickening of the septum in the MRI. What did your echo findings suggest? Do they point toward hypertrophic cardiomyopathy? We should rule out hypertrophic cardiomyopathy as well. If possible, please upload your echo, MRI, and routine ECG (electrocardiogram) for interpretation.
Regarding the possibility of viral myocarditis, it would typically show some changes on the echo or MRI. Therefore, this is also a less likely possibility if neither the echo nor MRI shows any consistent changes. Additionally, troponin levels would be positive in active myocarditis.
I would like to review your detailed report to see if we can find any clues regarding the diagnosis; otherwise, we will have to treat it as idiopathic VT (ventricular tachycardia).
Regards.
Patient's Query
Hi doctor,
Thank you for the reply.
I had an Ajmaline test, and they said it was unlikely to be a concern. Regarding the ECG, I had it done four times in the past two months, and it was normal each time, except for the most recent one, where the doctor noted a slight mitral regurgitation. As for the MRI, it only indicated mild mitral regurgitation. The doctor did not use a radiocontrast agent during the exam, which is why he suggested I repeat it twice.
Could you kindly explain this?
Hi,
Welcome back to icliniq.com.
Then we should wait for the contrast MRI. If it shows any lesions, we may gain some insight regarding the cause.
Patient's Query
Hi doctor,
Thank you for the reply.
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 taking Bisoprolol and Coenzyme Q10. Bisoprolol will help prevent the recurrence of ventricular tachycardia, while Coenzyme Q10 is beneficial for a healthy heart. The f waves are present, but they are nonspecific findings, and only one lead shows an epsilon-like wave, which is not observed in the other leads, so it is not very convincing. Additionally, there are no other significant ECG changes. Overall, the ECG is not sufficient to diagnose ARVC. We need more information, and a contrast MRI may reveal early changes.
Regards.
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Answered byDr. Sagar Ramesh Makode
Medically reviewed byDr. K. Shobana
Same symptoms don't mean you have the same problem. Consult a doctor now!
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