Suspected vasculitis in an adolescent female with cardiomyopathy, myocardial infarction, and heart failure requiring heart transplantation

A 15-year-old girl presented with dilated cardiomyopathy, positive cardiac markers, and electrocardiogram changes suggestive of acute coronary syndrome. Coronary angiography showed giant dilated coronary arteries. Pathological evidence for cardiomyopathy with acute myocardial infarction was present in the explanted heart. Further investigation suggested evidence for a systemic vasculitis: polyangiitis overlap syndrome.