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Heart failure symptoms common in arrhythmogenic right ventricular cardiomyopathy/dysplasia

02 Oct 2017

Symptoms of heart failure (HF), especially exertional dyspnoea, are common in arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D), a new study has shown.

“Given the unique predominately right-sided phenotype, a large portion of patients with HF may be under-recognized,” said researchers.

In the study sample of 289 ARVC/D patients (mean age of presentation 34±14 years), 142 had clinical HF while the remaining 147 did not. Isolated right ventricle involvement was documented in 80 percent (n=113) of the patients with HF.

Of the 142 patients who had clinical HF, a further 59 percent (n=84) had at least two symptoms while 27 percent (n=38) had at least three.

The most common symptom was dyspnoea on exertion, which was recorded in 78 percent (n=108) of the HF patients. This was followed by fatigue (73 percent; n=94), abdominal swelling (31 percent; n=36) and lower extremity swelling (28 percent; n=38).

Oedema or ascites, collectively defined in the study as volume overload, was observed in 57 patients (40 percent).

In contrast, left-sided symptoms were rare, the most common one being orthopnoea, which was observed only in 9 percent of the HF patients. This was followed by paroxysmal nocturnal dyspnoea (6 percent) and pulmonary rales (2 percent).

Moreover, while patients with clinical HF were significantly more likely to undergo heart transplantation (p<0.001), those with symptomatic left ventricular presentations were significantly more likely to receive it than those without (p=0.008).

Patients with heart failure (p=0.007), particularly those with left ventricle dysfunction (p=0.013), also had a higher risk of dying during follow-up.

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