47 F recurrent ADHF with inflammatory myocarditis
Age / Sex: 47-year-old female Comorbidities: Type 2 Diabetes Mellitus Late July / August 2025 (Initial Presentation) Chief Complaints: Giddiness, a single episode of transient loss of consciousness (LOC) lasting approximately 2 minutes, and one episode of vomiting. Pre-Hospital Course: Evaluated at an outside facility where she received an acute coronary syndrome (ACS) loading dose consisting of Acetylsalicylic Acid (Ecosprin) 325 mg, Clopidogrel (Clopitab), and Atorvastatin (Atorva) 80 mg prior to transfer. Emergency Department Presentation: The patient demonstrated profound bradycardia with a pulse rate of 40 bpm and initial hypotension measuring 100/60 mmHg, necessitating immediate inotropic and supplemental oxygen support. Following initial stabilization, vitals normalized to a blood pressure of 130/70 mmHg, respiratory rate of 20/min, and an $SpO_2$ of 98% on room air. Physical Examination: Systemic evaluation revealed adequate bilateral air entry, normal S1/S2 heart sounds ...