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A Case with Acute Myocarditis Presenting Succession of Fatal Arrhythmia Masking Cardiac Pump Failure Emi Maekawa 1,2 , Takayuki Inomata 1 , Yoshiro Chiba 2 , Hiroshi Fukunaga 2 , Fumio Yamashita 2 , Koji Ohhira 2 , Minoru Murata 2 , Tohru Izumi 1 1Department of Cardio-angiology, Kitasato University school of Medicine 2Department of Cardiology, Mito Saiseikai General Hospital Keyword: 急性心筋炎 , 致死的不整脈 , 心ポンプ失調 , acute myocarditis , fatal arrhythmia , cardiac pump failure pp.1311-1315
Published Date 2009/12/15
DOI https://doi.org/10.11477/mf.1404101394
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 A 58-year-old man was admitted to the hospital in November, 2007, due to repeated loss of consciousness. His vital signs remained within normal range and mechanical heart failure was not distinguished. His electrocardiogram showed prolonged PQ interval with two bundle branch blocks. This echocardiogram revealed that left ventricular wall motion was mildly hypokinetic with an ejection fraction level of 48%. Immediately after admission he had syncope together with complete atrioventricular block, leading to the functioning of his temporary back-up pacemaker. Short-run type of ventricular tachycardia was sometimes observed from day 2 and, finally, ventricular fibrillation occurred on day 5. Cardiac catheterization on day 6 demonstrated his coronary artery was quite normal and right ventricular endomyocardial biopsies documented active myocarditis. Cardiac pump failure was not apparent and masked by arrhythmic events during his stay in the hospital. Even the fatal arrhythmias also spontaneously disappeared within two weeks after the onset.

 It is important to be aware of acute myocarditis as a basic heart disease in cases in which a fatal arrhythmia event occurs, even if symptomatic cardiac pump failure is not obvious.


Copyright © 2009, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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