myocarditis;

Ecg A 14-year-old girl (176 cm, 60 kg) was referred to our hospi-tal with acute heart failure. She had a history of dyspnoea during a week. She developed orthopnoea and palpitations on the day of admission. The ECG of the referring hospital showed a bidirectional ventricular tachycardia (VT) (Figure 1A). She was transferred to our intensive care unit. After administration of amiodarone (300 mg/2 h fol-lowed by 900 mg/24 h iv), sinus rhythm was restored. Marked ST elevation became apparent in all leads (Figure 1B). After stabilization another ECG showed ventri-cular bigeminy (Figure 1C). Echocardiography was sugges-tive for acute myocarditis. Fulminant myocarditis was proven by endomyocardial biopsy. No aetiological agents could be withheld. After 4 days, our patient develope