Sudden Cardiac Death as the First Manifestation of Arrhythmogenic Right Ventricular Cardiomyopathy in a Young Female Athlete: Postmortem Morphologic Diagnosis.
4 affiliations
- 1Department of Pathology, University Clinical Center Kragujevac, Kragujevac, SRB.
- 2Department of Pathology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, SRB.
- 3Center for Vascular Surgery, University Clinical Center Kragujevac, Kragujevac, SRB.
- 4Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, SRB.
Abstract
We report a case of sudden cardiac death in a previously healthy 29-year-old female tennis player who collapsed during a family gathering with no prior cardiovascular symptoms and an unknown family history of sudden death or structural heart disease. A complete autopsy with histopathologic examination revealed a dilated right ventricle with wall thinning to 3 mm and focal transmural replacement of the myocardium by adipose tissue. Microscopically, the right ventricular wall consisted predominantly of adipose tissue, with small residual islands of hypertrophic cardiomyocytes, fibrosis, and sparse inflammatory infiltrates. A lateral left ventricular wall thickness of 15 mm, together with subepicardial fatty infiltration, prompted careful differential diagnostic consideration of athletic remodeling, hypertrophic cardiomyopathy, and biventricular or left-dominant phenotypes of arrhythmogenic cardiomyopathy. Toxicologic analysis was negative. The postmortem gross and histopathologic findings fulfilled major morphologic and histologic criteria and were highly consistent with arrhythmogenic right ventricular cardiomyopathy; however, in the absence of premortem imaging, electrocardiographic, and genetic data, this should be regarded as a postmortem morphologic diagnosis rather than a complete multiparametric diagnosis. This case underscores the diagnostic value of systematic autopsy and histopathologic examination following sudden unexplained death in young athletes, the importance of cautious interpretation of concomitant left ventricular findings, and the need for cardiovascular and genetic evaluation of first-degree relatives.
Related
- Elimination of Epicardial Late Potentials by Endocardial Ablation in Arrhythmogenic Right Ventricular Cardiomyopathy
- Incremental prognostic value of hepatic tissue alterations derived from cardiac magnetic resonance imaging for arrhythmogenic right ventricular cardiomyopathy: a case-control study
- Pathogenic variants in myoferlin (MYOF) cause arrhythmogenic cardiomyopathy
- Late Anthracycline Cardiotoxicity Mimicking Arrhythmogenic Cardiomyopathy in a Young Adult
- Stable truncating mutations in plakophilin-2 induce arrhythmogenic cardiomyopathy-like phenotypes in adult zebrafish
BibTeX
@article{deronjic2026sudden,
title = {{Sudden Cardiac Death as the First Manifestation of Arrhythmogenic Right Ventricular Cardiomyopathy in a Young Female Athlete: Postmortem Morphologic Diagnosis.}},
author = {Jelena Deronjic and Slobodanka Mitrovic and Marija Radojicic and Milena Ilic and Milica Dimitrijevic Stojanovic and Milos Milosavljevic and Dragan Knezevic and Dalibor Jovanovic},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116999},
url = {https://europepmc.org/article/MED/42948662},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sudden Cardiac Death as the First Manifestation of Arrhythmogenic Right Ventricular Cardiomyopathy in a Young Female Athlete: Postmortem Morphologic Diagnosis.
AU - Jelena Deronjic
AU - Slobodanka Mitrovic
AU - Marija Radojicic
AU - Milena Ilic
AU - Milica Dimitrijevic Stojanovic
AU - Milos Milosavljevic
AU - Dragan Knezevic
AU - Dalibor Jovanovic
PY - 2026
DA - 2026/09/27
JO - Cureus
DO - 10.7759/cureus.116999
UR - https://europepmc.org/article/MED/42948662
AB - We report a case of sudden cardiac death in a previously healthy 29-year-old female tennis player who collapsed during a family gathering with no prior cardiovascular symptoms and an unknown family history of sudden death or structural heart disease. A complete autopsy with histopathologic examination revealed a dilated right ventricle with wall thinning to 3 mm and focal transmural replacement of the myocardium by adipose tissue. Microscopically, the right ventricular wall consisted predominantly of adipose tissue, with small residual islands of hypertrophic cardiomyocytes, fibrosis, and sparse inflammatory infiltrates. A lateral left ventricular wall thickness of 15 mm, together with subepicardial fatty infiltration, prompted careful differential diagnostic consideration of athletic remodeling, hypertrophic cardiomyopathy, and biventricular or left-dominant phenotypes of arrhythmogenic cardiomyopathy. Toxicologic analysis was negative. The postmortem gross and histopathologic findings fulfilled major morphologic and histologic criteria and were highly consistent with arrhythmogenic right ventricular cardiomyopathy; however, in the absence of premortem imaging, electrocardiographic, and genetic data, this should be regarded as a postmortem morphologic diagnosis rather than a complete multiparametric diagnosis. This case underscores the diagnostic value of systematic autopsy and histopathologic examination following sudden unexplained death in young athletes, the importance of cautious interpretation of concomitant left ventricular findings, and the need for cardiovascular and genetic evaluation of first-degree relatives.
SN - 2168-8184
ER -