[Heart transplantation for dilated cardiomyopathy possibly caused by fulminant acute myocarditis: a case report].

A 13-year-old boy [corrected] underwent heart transplantation for severe congestive heart failure due to dilated cardiomyopathy possibly caused by fulminant acute myocarditis. He suddenly suffered chest discomfort and loss of consciousness during running, and was referred to a hospital with cardiogenic shock. Electrocardiography showed ventricular tachycardia and echocardiography revealed severe hypokinesis in an extensive area of the left ventricular wall with markedly decreased left ventricular ejection fraction. Percutaneous cardiopulmonary support, intraaortic balloon pumping and artificial respiration were performed. He suffered from severe heart failure with septic shock and bleeding tendency. A left ventricular assist system was fitted at 73 days after onset, and he was transferred to the National Cardiovascular Center on the 119th hospital day. At 319 days after the left ventricular assist system operation, heart transplantation was performed. The etiology and treatment for severe heart failure, and several social problems which occurred during care for heart transplantation are discussed.