RT Journal Article SR Electronic T1 A case of mistaken identity of arrhythmogenic right ventricular dysplasia in a 75-year-old patient JF BMJ Case Reports FD BMJ Publishing Group Ltd SP bcr0120091458 DO 10.1136/bcr.01.2009.1458 VO 2009 A1 Federica Iezzi A1 Roberto Cini A1 Daniela Baldini A1 Aldo Di Blasi YR 2009 UL http://casereports.bmj.com/content/2009/bcr.01.2009.1458.abstract AB We present an uncommon case of a 75-year-old woman who was admitted to our department for the evaluation of her double valvular disease that hid a diagnosis of arrhythmogenic right ventricular dysplasia (ARVD). In the course of preoperative workup, a mass of tissue substituting the right ventricular free wall was identified and documented with transthoracic echocardiography, computed tomography scanning, and nuclear magnetic resonance imaging. This pathology was not identified as ARVD. Before and after surgery (double valve replacement), malignant arrhythmias were observed and treated with an implantable cardioverter-defibrillator. The patient underwent reoperation 24 days later for endocarditis and died in the immediate postoperative period from untreatable ventricular arrhythmias. At autopsy the histological characteristics of ARVD were detected. This report highlights the difficulty in diagnosing ARVD in patients who do not fulfil the McKenna criteria.