Transient left ventricular aneurysm and hypertrophy accompanied by polymorphic ventricular tachycardia in a patient suspected of acute myocarditis

Jpn Heart J. 2000 Jan;41(1):97-102. doi: 10.1536/jhj.41.97.

Abstract

A 75-year-old woman presented with recurrent ventricular tachycardia (VT) compatible with torsades de pointes (TdP) based on sinus bradycardia and QT prolongation. Previously she had received pirmenol, at a serum concentration within therapeutic range, for her paroxysmal atrial fibrillation. Emergent cardiac catheterization identified a ventricular aneurysm of the anteroapical and inferior wall along with angiographically normal coronary arteries. A right ventricular endomyocardial biopsy revealed postmyocarditic change. The left ventricular contraction improved after 5 weeks of conservative treatment. A follow-up echocardiogram revealed transient thickening of partial left ventricular wall consistent with the segment of the aneurysm. Several months later, almost all abnormal findings had improved except for sustained deep negative T waves in precordial leads. Acute myocarditis was primarily suspected as the cause of her clinical presentation.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged
  • Biopsy, Needle
  • Echocardiography
  • Electrocardiography
  • Female
  • Heart Aneurysm / complications*
  • Heart Aneurysm / diagnosis
  • Humans
  • Hypertrophy, Left Ventricular / complications*
  • Hypertrophy, Left Ventricular / diagnosis
  • Myocarditis / complications*
  • Myocarditis / diagnosis
  • Tachycardia, Ventricular / complications*
  • Tachycardia, Ventricular / diagnosis