Case 144

Abstract

A 20-year-old woman is referred for management of refractory heart failure and consideration of heart transplantation. She was first seen at another hospital with a complaint of dyspnea that began about 3 weeks prior to her seeking medical attention. Prior to that she had been completely well and had participated in high school sports. She denied any recent substance abuse. Several relatives do have a history of myocardial infarctions in late middle age. Physical examination at her initial presentation revealed a persistent tachycardia at rates between 130 and 160 beats per min. Her ECG is shown in Fig. 144.1. © Springer-Verlag London Limited 2011.