Balloon mitral valvotomy (BMV) is the procedure of choice for rheumatic mitral stenosis with favorable valve morphology. Fracture of 0.025 inch coiled guidewire during BMV is a very rare complication. The various factors which may cause this complication are utilization of reused hardware, improper placement of guidewire, abnormal angulation between guidewire and dilator with forceful septal dilation and rarely manufacturing defect. Here, we report successful retrieval of broken 0.025 inch coiled guidewire from left atrium during BMV using 10F Amplatzer long sheath without any complication.

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Background: Sudden cardiac death is a catastrophic event which leads to loss of young and middle-aged population with dire consequences. Sometimes, a careful history, physical examination and most importantly electrocardiogram (ECG) can help in suspecting the common causes in young population like underlying channelopathies and cardiomyopathies which can further be diagnosed using echocardiography, cardiac MRI and in some cases genetic tests.Case summary: A 33-year-old male presented with sycope and ventricular tachycardia leading to death. This patient was diagnosed to have Arrythmogenic right ventricular dysplasia (ARVD) on post mortem pathological examination with features of fatty infiltration and thinning of right ventricular myocardium. Furthermore, on histologically fatty infiltration with inflammatory infiltrates were visualized.Discussion: Clinical awareness amongst physicians about cardiomyopathies especially ARVD with its subtle yet suggestive ECG changes is the need of the hour. ARVD is a rare disease and can be diagnosed with certainty by analyzing ECG and adding imaging to it. When diagnosed cases are treated appropriately, at least a few cases of sudden cardiac death can be averted.

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