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Patients can present with a predominant metabolic or cardiac presentation or with both (Table 96-1)

For instance, the active exclusion of Ca 2+ from the cytosol is impaired, 43 and the resulting increase in cytosolic Ca 2+ induces its uptake by mitochondria, leading to mitochondrial dysfunction and the opening of the mitochondrial permeability transition pore (MPTP)as a cause of cell death

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