title: Transient left ventricular aneurysm and hypertrophy accompanied by polymorphic ventricular tachycardia in a patient suspected of acute myocarditis.
abstract: A 75-year-old woman presented with recurrent ventricular tachycardia (VT) compatible with torsades de pointes (TdP) based on sinus bradycardia and QT prolongation. Previously she had received pirmenol, at a serum concentration within therapeutic range, for her paroxysmal atrial fibrillation. Emergent cardiac catheterization identified a ventricular aneurysm of the anteroapical and inferior wall along with angiographically normal coronary arteries. A right ventricular endomyocardial biopsy revealed postmyocarditic change. The left ventricular contraction improved after 5 weeks of conservative treatment. A follow-up echocardiogram revealed transient thickening of partial left ventricular wall consistent with the segment of the aneurysm. Several months later, almost all abnormal findings had improved except for sustained deep negative T waves in precordial leads. Acute myocarditis was primarily suspected as the cause of her clinical presentation.
authors.affiliation: First Department of Internal Medicine, Shinshu University School of Medicine, Tokyo, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Izawa
authors.forename: Y
authors.initials: Y
authors.lastname: Yazaki
authors.forename: S
authors.initials: S
authors.lastname: Hayashi
authors.forename: H
authors.initials: H
authors.lastname: Imamura
authors.forename: Y
authors.initials: Y
authors.lastname: Kusama
authors.forename: M
authors.initials: M
authors.lastname: Isobe
mesh_terms: D000208:Acute Disease; D000368:Aged; D001707:Biopsy, Needle; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006322:Heart Aneurysm / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000175:diagnosis; D009205:Myocarditis / Q000150:complications* / Q000175:diagnosis; D017180:Tachycardia, Ventricular / Q000150:complications* / Q000175:diagnosis