case_images: PMC6232831_01
case_images: 2D echo (four-chamber view) during systole with LVEF of 20-25% (courtesy of Mt. Sinai Hospital Cardiology Department).
case_images: CRIID2018-4258296.001.jpg
case_images: PMC6232831_01_CRIID2018-4258296.001.jpg
case_images: fig1
case_images: Subsequent imaging showed a low-probability VQ scan for pulmonary embolism, and severe diffuse myocardial hypokinesis with left ventricular ejection fraction (LVEF) of 20-25% without pericardial effusion on 2D Echo (Figure 1).
case_images: (a) Myocardial biopsy with inflammatory infiltrate; (b) lymphocytic infiltrate; (c) focal myocyte necrosis (arrow); (d) immunohistochemical stain for CD3 highlighting T cells (courtesy of Mt. Sinai Hospital Pathology Department).
case_images: CRIID2018-4258296.002.jpg
case_images: PMC6232831_01_CRIID2018-4258296.002.jpg
case_images: fig2
case_images: With a presumptive diagnosis of fulminant acute myocarditis, right ventricular endomyocardial biopsy (EMB) was performed disclosing a lymphocytic infiltrate with focal myocyte necrosis along with immunohistochemical stain for CD3 demonstrating presence of T cells (Figure 2).