A man in his 20s with syncope and shortness of breath developed worsening cardiogenic shock and incessant polymorphic ventricular tachycardia despite negative findings on endomyocardial biopsy. This echocardiogram taken during temporary biventricular assist device implantation illustrates continuous regurgitant mitral valve flow caused by ventricular fibrillation and complete loss of cardiac contractility. A repeated biopsy confirmed giant cell myocarditis. The patient began immunosuppressive treatment but died awaiting cardiac transplantation. Click the Related Article link for complete case details.
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