Abstract
A 40-year-old Caucasian male executive was in apparently excellent health until December 1984, when over a two-month period he developed persistent fatigue, lightheadedness, and palpitations, for which he sought medical attention. He was found to have congestive heart failure and was hospitalized. In February 1985, normal coronary arteries and a dilated, hypokinetic left ventricle with an ejection fraction of 25 percent were demonstrated by cardiac catheterization. Endomyocardial biopsy, performed to exclude myocarditis, showed no inflammatory cells, but disclosed myocyte hypertrophy and interstitial fibrosis suggesting a chronic process. He responded well to treatment with digoxin, diuretics, and procainamide, returning to work full time and leading an active life. In April 1988, he developed increasing fatigue and severe shortness of breath, for which he was admitted to another hospital. He was again noted to have congestive heart failure but improved quickly, losing 25 pounds with intravenous diuretic therapy. Over the next three months he was hospitalized on three more occasions because of paroxysmal atrial fibrillation and decompensated heart failure. Despite adjustments in his medical regimen, he continued to deteriorate, and in June 1988 was referred to University Hospitals for cardiac transplantation.
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© 1989 Plenum Publishing Corporation
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Starling, R.C. (1989). Cardiac Transplantation. In: Bowen, J., Mazzaferri, E.L. (eds) Contemporary Internal Medicine. Contemporary Internal Medicine, vol 2. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-6716-5_17
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DOI: https://doi.org/10.1007/978-1-4615-6716-5_17
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