Sheeza Basharat10 months ago

Diagnose it!

38-year-old man dies suddenly at his workplace and cannot be resuscitated. He had experienced chest discomfort, shortness of breath, and fatigue in the week preceding the event. The man was overweight but otherwise had no significant medical history. He had no established primary care physician. He did not use alcohol, tobacco, or illicit drugs. Both parents are alive and healthy; a maternal uncle reportedly died of a heart attack at age 50. Autopsy was performed and myocardial findings are shown in the slide above. Which of the following is the most likely diagnosis? A. Acute myocarditis B. Cardiac amyloidosis C. Congenital long QT syndrome D. Early-onset coronary artery disease E. Hypertrophic cardiomyopathy. ......... This patient likely died from acute myocarditis, a condition most often caused by viral infection. Numerous viruses, including coxsackievirus, adenovirus, influenza, and HIV have been implicated. Histopathology typically shows myofibrillary necrosis accompanied by inflammatory mononuclear cell infiltrate consisting of lymphocytes and some macrophages . Other less common etiologies of acute myocarditis, including bacterial, parasitic, and rheumatologic, often have similar histologic appearance but may demonstrate additional findings (eg, granulomas in mycobacterial disease, visible organisms in parasitic disease). The clinical presentation of acute myocarditis can vary significantly; many patients remain asymptomatic with subclinical infection, but some experience severe complications including decompensated heart failure (eg, dyspnea, fatigue, peripheral edema) due to dilated cardiomyopathy. Ventricular arrhythmias leading to sudden cardiac death (SCD) can also occur.