Case Report: Acute Biventricular failure and Cardiopulmonary arrest due to Acute Fulminant myocarditis in Young patient

A 41-year-old Afro-Caribbean woman presented to the emergency department with three days history of worsening chest pain, electrocardiography revealed mild diffuse ST segment elevation with poor R wave progression, urgent transthoracic echocardiogram (TTE) has shown severe biventricular global systolic dysfunction and a small pericardial effusion, high-sensitivity troponin T level was 564 ng/ml (TNT), a diagnosis of myocarditis was established and the patient treated with intravenous opiates and glucocorticoids, an hour later, the patient had a cardiopulmonary arrest with pulseless electrical activity. She was received advanced cardiopulmonary life support for 5 minutes, spontaneous circulation returned, while preparing the extracorporeal membrane oxygenation (ECMO), patient had another cardiopulmonary arrest second time around with ventricular fibrillation, although despite prolonged advanced cardiopulmonary life support, unfortunately the patient has passed away. An autopsy Study revealed microscopically subtle interstitial inflammatory infiltrate and oedema throughout the myocardium with a small amount of straw-coloured fluid in the pericardial space. The diagnosis of fulminant myocarditis was reached.