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Seronegative immune-mediated necrotising myopathy complicated by fulminant myocarditis resulting in cardiogenic shock and cardiac arrest
  1. Darren Tsang,
  2. Chaitanya Lakshmidhar Malladi,
  3. Komal Patel and
  4. Puneet Bajaj
  1. Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
  1. Correspondence to Dr Chaitanya Lakshmidhar Malladi; clmalladi{at}


A woman in her late 30s recently diagnosed with viral myopericarditis presented with 1 month of worsening fatigue, diffuse myalgias and chest pain radiating to her back. While undergoing work-up for chest wall myositis, she rapidly decompensated, developing heart failure and acute hypoxaemic respiratory failure. Her clinical course was complicated by cardiac arrest and severe cardiogenic shock requiring intra-aortic balloon pump support.

  • Heart failure
  • Biological agents
  • Connective tissue disease
  • Musculoskeletal syndromes

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  • Contributors DT and CLM were cofirst authors. They both participated as the primary authors of the manuscript, analysis and interpretation of data, and final approval of the version published. CLM, KP and PB participated in the treatment of the patient. KP and PB participated as a major contributors to the drafting of the manuscript, providing major revisions to the draft as necessary, analysis and interpretation of data, and final approval of the version published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.