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  • Title: [Fulminant myocarditis causing severe left heart failure and massive thrombus formation following cardiac tamponade: a case report].
    Author: Miyamoto K, Yasuda S, Noguchi T, Tanimoto T, Kakuchi H, Morii I, Kawamura A, Nakatani T, Nonogi H, Goto Y, Miyazaki S.
    Journal: J Cardiol; 2005 Jul; 46(1):25-31. PubMed ID: 16095228.
    Abstract:
    A woman aged middle thirties presented with common cold-like symptoms, and was hospitalized due to hypotension and tachycardia. Echocardiography revealed pericardial effusion and preserved left ventricular fractional shortening (28%). Cardiac index, pulmonary capillary wedge and right atrial pressure were 1.8 l/min/m2, 15 and 13 mmHg, respectively. After drainage of pericardial effusion, cardiac index increased to 3.4 l/min/m2. On the fifth hospital day, left ventricular dysfunction developed (fractional shortening: 16%, cardiac index: 1.5 l/min/m2, pulmonary capillary wedge pressure: 18 mmHg, right atrial pressure: 12 mmHg), so percutaneous cardiopulmonary support was introduced. However, the heart failed in asystole and the cavity was occupied by massive thrombus, probably related to heparin-induced thrombocytopenia. This case of fulminant myocarditis passed through various clinical features of heart failure. She died on the 12th hospital day.
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