Aborted sudden death in a young patient with isolated granulomatous myocarditis

A young athlete was successfully resuscitated from ventricular fibrillation. Subsequently severe heart failure developed and endomyocardial biopsy showed granulomatous myocarditis. Following steroid therapy, repeated biopsies demonstrated partial resolution of the inflammatory changes and mild myocardial fibrosis; the granulomas disappeared, and the patient recovered both clinically and haemodynamically. Three years later, the patient is asymptomatic, is practising long distance jogging, has a normal left ventricular ejection fraction and no evidence of arrhythmias.