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A 45-year-old man with a rapidly deteriorating heart condition died suddenly, two hours after admission, after resistance to attempts of cardiac pacing. At autopsy, the heart weighed 600g with asymmetric septal hypertrophy. Histological examination revealed an extensive and diffuse disarray of myocardial fibers in the ventricular septum and in the free wall of both ventricles. Pronounced mononuclear cell infiltrations and interstitial edema were distributed widely in both ventricles. There were few abnormal findings in the other organs. The diagnosis was hypertrophic cardiomyopathy accompanied by Fiedler's myocarditis. Such a case appears to be rare.

Sudden Cardiac Death from Hypertrophic Cardiomyopathy and Acute Idiopathic (Fiedler's) Myocarditis: Autopsy Report.