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- W2740410584 abstract "A 66-year-old healthy male presented with multiple episodes of presyncope and syncope with only significant relevant history of sudden death in brother at the age of 50. Cardiac troponin T was significantly elevated in the setting of normal coronaries and structurally and functionally normal heart. Patient developed witnessed episodes of syncope with corresponding widespread conduction disease on ECGs as evidenced by sinus pauses, high degree AV block and bifasicular block. After reversible causes were excluded, patient received dual chamber permanent pacemaker. He represented 3 weeks later with rapidly progressive symptoms of left ventricular failure with marked elevation of cardiac troponins. Transthoracic echocardiogram revealed severe global impairment of LV and RV systolic function without any evidence of infiltrative cardiomyopathy. The patient deteriorated rapidly progressing to cardiogenic shock and multi-organ failure requiring inotropic support and urgent referral to transplant centre. Right ventricular endomyocardial biopsy showed myocyte necrosis with mixed inflammatory infiltrate and scattered multinucleated giant cells consistent with giant cell myocarditis. Patient required urgent placement of temporary biventricular assist device as a bridge to cardiac transplantation. Patient passed away 2 weeks after the second presentation. Our case highlights that giant cell myocarditis is a rare but important consideration in middle aged patients presenting with severe conduction disease and sudden onset heart failure without any other alternative explanation [[1]Cooper L.T. Berry G.J. Shabetai R. Idiopathic giant-cell myocarditis - natural history and treatment.N Engl J Med. 1997; 336: 1860-1866Crossref PubMed Scopus (577) Google Scholar]. Referral to transplant centre is important early in the course of disease given rapidly progressive nature of the disease." @default.
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- W2740410584 date "2017-01-01" @default.
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- W2740410584 title "A Case of Giant Cell Myocarditis Presenting with Rapidly Progressive Conduction Disease and Heart Failure" @default.
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- W2740410584 doi "https://doi.org/10.1016/j.hlc.2017.06.189" @default.
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