Sudden 2

A 20 year old woman presents with worsening exertional dyspnea for 2 days.

She developed a fever 7 days ago, which was associated with coryza and rhinorrhea, and which subsided after 4 days.

Her medical history is otherwise unremarkable.

Select Relevant Investigations
Full Blood Count

Performed

WBC/DC: 6,000/mm3
Neutrophils: 50%
Lymphocytes: 50%

Hb: 12.2 g/dL
Hct (PCV): 35%

Platelets: 228,000/mm3
ECG

Performed

There are T inversions in all leads. Serial ECGs show no dynamic changes.
Echocardiogram

Performed

There is global hypokinesis and mild dilation of both ventricles, with a jerky myocardium. There are multiple regional wall motion abnormalities and the ejection fraction is 40%.
Endomyocardial biopsy

Performed

The endomyocardial biopsy shows a lymphocytic inflammatory infiltrate with evidence of myocyte necrosis.

Select Relevant Management
Calcium channel blockers
Diuretics
IV Antibiotics stat
Corticosteroids