Arrhythmogenic cardiomyopathy: right, left, both

The index case is a 64-year-old man with past medical history of emphysema, who was found dead at home. cause death autopsy ischaemic heart disease. An incidental finding myocyte necrosis, fibrosis and fatty infiltration in the left ventricle epicardium, suggestive arrhythmogenic cardiomyopathy (ACM). Family members were referred for further investigation. ACM rare genetic condition associated sudden death. Fibrofatty tissue replaces myocardium, starting from epicardial surface. often described right although ventricular involvement possible. Cases over 22 years reviewed large mortuary. In 19 cases, diagnosed certainty, while ‘suspected ACM’ 23 cases. latter cohort had more comorbidities decedents older. combined group 42 individuals, distribution pathology as follows: 57% biventricular, 29% 14% ventricle. can be subtle finding, but significant implications family. We share macro microscopic features compare differences amongst versus suspected Issues search satisfaction diagnostic uncertainty older co-morbid patients are discussed.