018 Myocarditis Polysubstance VF arrest

POLY SUBSTANCE ABUSE, VF ARREST, NEG CORONARIES

55-year-old male with no prior cardiac history became unresponsive during sexual intercourse. Required CPR and defibrillation, and subsequently required epinephrine drip
Echo showed EF 50-55%, and normal cardiac chambers.
CXR showed CHF and LAE

CXR LAE CHF with INTERSTITIAL EDEMA- POLY SUBSTANCE ABUSE VF ARREST NEG CORONARIES
Ashley Davidoff MD

Cardiac Cath showed normal coronaries, PCW 25 mm Hg

MRI showed mildly dilated LV and normal sized left atrium, right atrium and right ventricle.

Ejection fraction was 47% and myocardial mass was 61g/sqm. End diastolic volume was 160 ccs. Associated findings included bilateral pleural effusions.

POLY SUBSTANCE ABUSE VF ARREST NEG CORONARIES
Ashley Davidoff MD
POLY SUBSTANCE ABUSE VF ARREST NEG CORONARIES
Ashley Davidoff MD

Normal RV Function

POLY SUBSTANCE ABUSE VF ARREST NEG CORONARIES
Ashley Davidoff MD

There was LGE in the mid myocardium in the apical anterior wall . Finding were most consistent with a myocarditis, or sarcoidosis. Also included in the differential diagnosis was methamphetamine analogue use.

NODULAR LGE MID MYOCARDIAL INFEROLATERAL-POLY SUBSTANCE ABUSE VF ARREST NEG CORONARIES
Ashley Davidoff MD
MID MYOCARDIAL LINEAR LGE INFERIOR AND APICAL – POLY SUBSTANCE ABUSE VF ARREST NEG CORONARIES
Ashley Davidoff MD

CXR following placement of a pacemaker/defibrillator showed improved CHF

PACEMAKER – IMPROVED CXR – POLY SUBSTANCE ABUSE VF ARREST NEG CORONARIES
55-year-old male with no prior history became unresponsive during sexual intercourse. Required CPR and defibrillation, and subsequently required epinephrine drip
Echo showed EF 50-55%, and normal cardiac chambers.
CXR showed CHF and LAE
Cardiac Cath showed normal coronaries, PCW 25 mm Hg
MRI showed mildly dilated LV and normal sized left atrium, right atrium and right ventricle. There was LGE in the mid myocardium in the apical anterior wall . Ejection fraction was 47% and myocardial mass was 61g/sqm. End diastolic volume was 160 ccs. Associated findings included bilateral pleural effusions. Finding were most consistent with a myocarditis, or sarcoidosis. Also included in the differential diagnosis was methamphetamine analogue use.
CXR following placement of a pacemaker/defibrillator showed improved CHF
Ashley Davidoff MD

Ashley Davidoff MD