case_images: PMC10310455_01
case_images: Electrocardiogram demonstrating atrial tachycardia with 127 beats per minute and a right bundle branch block configuration.
case_images: CRIC2023-7646962.001.jpg
case_images: PMC10310455_01_CRIC2023-7646962.001.jpg
case_images: fig1
case_images: Electrocardiogram showed an atrial tachycardia and a right bundle branch block (Figure 1).
case_images: Transthoracic echocardiography showing four chamber cardiac view.
case_images: CRIC2023-7646962.002.jpg
case_images: PMC10310455_01_CRIC2023-7646962.002.jpg
case_images: fig2
case_images: Pericardial effusion could be ruled out as well as a valvular heart disease (Figure 2).
case_images: CMR imaging study showing severe LV dysfunction and signs of acute myocarditis. (a and c) Three-chamber views, (b and d) short axis views. (a and b) LGE images with severe subepicardial to transmural LGE inferolateral and anterolateral. (c and d) Native T1-maps with focal increased native T1 values in LGE positive regions.
case_images: CRIC2023-7646962.003.jpg
case_images: PMC10310455_01_CRIC2023-7646962.003.jpg
case_images: fig3
case_images: Additionally, enlarged mediastinal and hilar lymph nodes could be detected and a minimal left sided pericardial effusion (Figures 3(a), 3(b), 3(c), and 3(d)).
case_images: Histopathological images. (a) Histological findings in the endomyocardial biopsy showing active lymphocytic myocarditis with necrosis and areas of organization (Giemsa), (b) CD3 and T-cells, and (c) CD 68 and macrophages.
case_images: CRIC2023-7646962.004.jpg
case_images: PMC10310455_01_CRIC2023-7646962.004.jpg
case_images: fig4
case_images: Histology and immunohistology of the EMB revealed an acute lymphocytic myocarditis with focal myocyte necrosis and infiltration of CD3+ T cells and CD68+ macrophages on day 13 (Figures 4(a), 4(b), and 4(c)).
case_images: Electrocardiogram demonstrating non-sustained ventricular tachycardia and frequent premature ventricular complexes.
case_images: CRIC2023-7646962.005.jpg
case_images: PMC10310455_01_CRIC2023-7646962.005.jpg
case_images: fig5
case_images: On day 17, a non-sustained ventricular tachycardia was documented (Figure 5).