Correct!
4. Lung transplantation
Removal of the offending agent is usually recommended although amiodarone has a very long elimination half-life and this alone is often ineffective. Of course, supportive care is recommended but the mainstay of therapy is corticosteroids. These are usually initiated at 0.5-1 mg/ kg and tapered gradually as tolerated over 2-6 months. Symptoms can recur during taper and returning to the last effective dose and then slowly tapering is recommended.
Therapy for our patient was initiated with high-dose corticosteroids which resulted in improved oxygenation. However, he developed subcutaneous emphysema with a persistent airleak, volume overload requiring hemofiltration, elevated liver function tests, thrombocytopenia, and functional deficits requiring rehabilitation.
He slowly improved on tapering doses of prednisone and had no recurrence of symptoms. His SpO2 is 95% on room air and is walking 1000 feet and doing 30 deep knee bends without dyspnea. He has no recurrence of his ventricular tachycardia.
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