title: Cardiogenic shock due to left ventricular outflow obstruction and complete atrioventricular block in a patient with hypertrophic cardiomyopathy with acute myocarditis.
abstract: A 67-year-old woman was referred to our hospital with a sudden syncopal attack. She suffered from cardiogenic shock due to left ventricular (LV) outflow stenosis with simultaneous complete atrioventricular (AV) block. An endomyocardial biopsy of the left ventricle demonstrated myocardial disarray and myocardial fibrous and edematous tissue with infiltration of mononuclear cells. Cardiac magnetic resonance imaging (cMRI) detected a damaged septal area that was likely associated with the conduction disturbance. The diagnosis was hypertrophic cardiomyopathy accompanied by acute myocarditis. Although the LV outflow stenosis was transient, the complete AV block was persistent, thus requiring permanent pacemaker implantation.
authors.affiliation: Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.
authors.forename: Saburo
authors.initials: S
authors.lastname: Kusumoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kawano
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Takeno
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yonekura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Koide
authors.forename: Kuniko
authors.initials: K
authors.lastname: Abe
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Doi
authors.forename: Satoki
authors.initials: S
authors.lastname: Fukae
authors.forename: Norihiro
authors.initials: N
authors.lastname: Komiya
authors.forename: Koji
authors.initials: K
authors.lastname: Maemura
mesh_terms: D000208:Acute Disease; D000368:Aged; D054537:Atrioventricular Block / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D001706:Biopsy; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009205:Myocarditis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D009206:Myocardium / Q000473:pathology; D010138:Pacemaker, Artificial; D012770:Shock, Cardiogenic / Q000175:diagnosis* / Q000209:etiology*; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology