| Summary points: | A 10-year, 11-month-old girl with severe mitral valve regurgitation, stenosis, and dilated cardiomyopathy presents with New York Heart Association functional classification IV. She acutely developed cardiogenic shock with a dyskinetic anterior-septal left ventricle and entered a shock state during consultation about heart transplantation. Chest x-ray, echocardiogram, cardiac catheterisation, cardiac muscle biopsy, and treatment are described. The authors recommend the septal anterior ventricular exclusion (SAVE) procedure for children with a large non-functional LV area for use between medical treatment and heart transplantation. |