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S.N. van der Crabben is a member of the European Reference Network for rare, low prevalence, and/or complex diseases of the heart: ERN GUARD-Heart
A 25-year-old man was referred for genetic analysis of his cardiac arrhythmia. The otherwise healthy man had experienced exercise-induced atrial fibrillation (AF) at the age of 16 years. Seven years later AF recurred, again induced by exercise. He underwent chemical conversion. The findings of an extended cardiological examination (cardiac MRI and exercise test) were normal, revealing only a sinus bradycardia of 52 beats/min. His maternal grandfather had AF and received a pacemaker at the age of 79 years because of symptomatic bradycardia. During history taking at the clinical genetics outpatient clinic the skin abnormality shown in Fig. 1 was noted. The patient reported that his paternal grandfather had the same skin abnormality. What is the diagnosis of this skin abnormality and (how) does it relate to his (familial) AF?
Fig. 1
Forearm of the patient (with patient’s oral and written permission)
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Answer
You will find the answer elsewhere in this issue.
Conflict of interest
L.V.A. Boersma is an editor of the Netherlands Heart Journal. A. Bochem and S.N. van der Crabben declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...
