case_images: PMC7428952_01
case_images: Coronary angiography on presentation. (a) Right anterior oblique and caudal projection and (b) right anterior oblique and cranial projection of the left coronary arteries demonstrating mild coronary artery disease. (c) Cranial projection of the right coronary artery demonstrating mild coronary artery disease; extracorporeal membranous oxygenation venous cannula originating from the femoral vein and extending into the right atrium can be seen (arrow).
case_images: CRICC2020-8881042.001.jpg
case_images: PMC7428952_01_CRICC2020-8881042.001.jpg
case_images: fig1
case_images: A coronary angiography was then performed that demonstrated mild coronary artery disease (Figure 1).
case_images: Transthoracic echocardiogram on admission demonstrating severe left ventricular (LV) systolic dysfunction with an ejection fraction of 20%. (a) Two-chamber view of LV end diastole and (b) LV end systole.
case_images: CRICC2020-8881042.002.jpg
case_images: PMC7428952_01_CRICC2020-8881042.002.jpg
case_images: fig2
case_images: Transthoracic echocardiogram demonstrated severe left ventricle (LV) systolic dysfunction with an ejection fraction of 20% and a dilated LV (LV end diastolic and systolic volume indexes were 92 mL/m2 and 72 mL/m2, respectively) (Figure 2).
case_images: Cardiac magnetic resonance imaging of parasternal short axis. (a) T2-weighted images demonstrating extensive myocardial T2 elevation (arrow) of the left ventricle (LV) consistent with myocardial edema. (b) Extensive LV patchy, epicardial pattern of injury by late gadolinium enhancement (arrow) consistent with cellular membrane injury; there was no infarct scar seen. There was severe LV systolic dysfunction with an ejection fraction of 25%. These findings are consistent with a diagnosis of acute myocarditis.
case_images: CRICC2020-8881042.003.jpg
case_images: PMC7428952_01_CRICC2020-8881042.003.jpg
case_images: fig3
case_images: Cardiac magnetic resonance imaging was obtained on hospital day 10 and demonstrated severe LV systolic dysfunction with an ejection fraction of 25%; there was also extensive epicardial late gadolinium enhancement and elevated T2 signal consistent with acute myocarditis (Figure 3).