A 23 year old woman is brought to the hospital because of progressive shortness of breath and palpitations for 5 days. She had a flu like illness 2 weeks ago. Temperature is 38 C (100.4 F). Physical examination shows tachycardia, bibasilar crackles, and mild lower extremity edema. Troponin is mildly elevated. Echocardiography shows global systolic dysfunction with a reduced ejection fraction. Endomyocardial biopsy would most likely show which of the following?

  1. A)Neutrophilic infiltration with liquefactive necrosis
  2. B)Amyloid deposition with apple green birefringence
  3. C)Fibrofatty replacement of the right ventricular free wall
  4. D)Noncaseating granulomas with giant cells
  5. E)Lymphocytic interstitial infiltrates with myocyte necrosisGABARITO

Explicação

Lymphocytic interstitial infiltrates with myocyte necrosis is correct. Viral myocarditis often follows a recent flu like illness and presents with chest symptoms, arrhythmia, and new systolic heart failure. Coxsackievirus B and other viruses classically produc... Ver explicação completa e trilha adaptativa →

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