PMC3061208_01
ECG in baby A at first presentation
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Fig1
An electrocardiogram revealed ST-depression in right precordial leads and aVR, and ST elevation in I and II (Fig. 1) Laboratory data showed increased cardiac enzymes consistent with myocardial damage (Table 1).
Fibrosis in the postlateral wall of dilated left ventricle with hypertrophy of right ventricle and septum
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Fig2
Furthermore, microscopy showed global subendocardial fibroelastosis with scar tissue in the lateral wall of the left ventricle, including the papillary muscles, associated with loss of myocytes and hypertrophy of residual myocytes (Figs. 2, 3).
Left panel Postlateral wall of the left ventricle with scar tissue (blue) and residual myocytes (Masson staining [20x]). Right panel Lung with alveolar and septal hemosiderophages (blue), consistent with venous congestion (Prussian Blue staining [100x])
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Fig3
Furthermore, microscopy showed global subendocardial fibroelastosis with scar tissue in the lateral wall of the left ventricle, including the papillary muscles, associated with loss of myocytes and hypertrophy of residual myocytes (Figs. 2, 3). Microscopy of both lungs demonstrated alveolar and septal hemorrhage as well as hemosiderophages as a sign of long-standing venous congestion due to left-ventricular failure. (Fig. 3).