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Cardiovascular Images
June 3, 2020

A Man in His 20s With New-Onset Severe Heart Failure and Ventricular Tachycardia

Author Affiliations
  • 1Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 2Cardiology Section, Department of Medicine, Veterans Affairs Boston Healthcare System, Boston, Massachusetts
  • 3Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
JAMA Cardiol. Published online June 3, 2020. doi:10.1001/jamacardio.2020.1054

A man in his 20s presented with syncope and shortness of breath. Electrocardiography revealed monomorphic ventricular tachycardia. Echocardiography demonstrated severe biventricular dysfunction with normal ventricular size and thickness. Septal e' was 5 cm/s, mitral valve inflow deceleration time was 120 milliseconds, E/e' was 18, and lateral s' was 6 cm/s. An endomyocardial biopsy did not show any specific pathology. In this patient with severe heart failure, ventricular arrhythmias, and unrevealing biopsy, what should be the next step?

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