Transient left ventricular aneurysm and hypertrophy accompanied by polymorphic ventricular tachycardia in a patient suspected of acute myocarditis.
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.
Izawa
A
A
First Department of Internal Medicine, Shinshu University School of Medicine, Tokyo, Japan.
Yazaki
Y
Y
Hayashi
S
S
Imamura
H
H
Kusama
Y
Y
Isobe
M
M
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