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Bedani E, Girerd R, Beti E. Une myocardite aiguë mimant un syndrome coronarien aigu. ANNALES FRANCAISES DE MEDECINE D URGENCE 2019. [DOI: 10.3166/afmu-2018-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Peters AE, Loffler A, Kramer CM, Salerno M, Kwon Y. Recurrent Myocarditis Imitating ST Segment Elevation Myocardial Infarction. J Med Cases 2019; 9:239-242. [PMID: 30906487 PMCID: PMC6425956 DOI: 10.14740/jmc3081w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Acute myocarditis mimicking ST segment elevation myocardial infarction is a well-known phenomenon, but recurrence and progression are rare. We present a case of a 29-year-old man with three episodes of myocarditis over 3 months including evidence of progressive, patchy inflammation shown by cardiovascular magnetic resonance imaging.
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Affiliation(s)
- Anthony E Peters
- Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA
| | - Adrian Loffler
- Department of Medicine, Cardiology Division, University of Virginia Health System, Charlottesville, VA, USA.,Department of Radiology, Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA
| | - Christopher M Kramer
- Department of Medicine, Cardiology Division, University of Virginia Health System, Charlottesville, VA, USA.,Department of Radiology, Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA
| | - Michael Salerno
- Department of Medicine, Cardiology Division, University of Virginia Health System, Charlottesville, VA, USA.,Department of Radiology, Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA.,Department of Biomedical Engineering, University of Virginia Health System, Charlottesville, VA, USA
| | - Younghoon Kwon
- Department of Medicine, Cardiology Division, University of Virginia Health System, Charlottesville, VA, USA
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Floyd A, Lal A, Molina K, Puchalski M, Miller D, May L. When Lightning Strikes Twice in Pediatrics: Case Report and Review of Recurrent Myocarditis. Pediatrics 2018; 141:peds.2016-4096. [PMID: 29437909 DOI: 10.1542/peds.2016-4096] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2017] [Indexed: 11/24/2022] Open
Abstract
Myocarditis is an important but incompletely understood cause of cardiac dysfunction. Children with fulminant myocarditis often require inotropic or mechanical circulatory support, and researchers in some studies suggest that up to 42% of children who die suddenly have evidence of myocarditis. Recurrent myocarditis is extremely rare, and the vast majority of reported cases involve adult patients. Pediatric providers who suspect a recurrence of myocarditis have limited evidence to guide patient management because the literature in this domain is sparse. Here we present a unique, illustrative pediatric case of recurrent myocarditis. A 14-year-old boy presented for the second time in 2 years with a clinical history strongly suggestive of myocarditis. Although myocarditis was suggested in the results of cardiac MRI, no pathogen was identified during his first presentation. During his second episode of myocarditis, parvovirus was confirmed by polymerase chain reaction testing of an endomyocardial specimen that also met Dallas criteria for myocarditis. With each presentation, he had decreased ventricular function that subsequently normalized. To the best of our knowledge, there are no reports of recurrent myocarditis in children in whom the diagnosis was confirmed by using MRI and/or biopsy data. Reviewing this distinctive case and the existing literature may help characterize this entity and raise awareness among care providers.
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Affiliation(s)
- Alisha Floyd
- Primary Children's Hospital and Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Ashwin Lal
- Primary Children's Hospital and Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Kimberly Molina
- Primary Children's Hospital and Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Michael Puchalski
- Primary Children's Hospital and Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Dylan Miller
- Primary Children's Hospital and Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Lindsay May
- Primary Children's Hospital and Department of Pediatrics, University of Utah, Salt Lake City, Utah
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Zhang T, Miao W, Wang S, Wei M, Su G, Li Z. Acute myocarditis mimicking ST-elevation myocardial infarction: A case report and review of the literature. Exp Ther Med 2015; 10:459-464. [PMID: 26622337 PMCID: PMC4508986 DOI: 10.3892/etm.2015.2576] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 06/01/2015] [Indexed: 01/05/2023] Open
Abstract
The present study describes the case of a young man aged 22 who had acute retrosternal pain, elevated cardiac markers and electrocardiographic ST-T changes, which led to an original misdiagnosis of acute myocardial infarction. The patient underwent immediate coronary angiography, which revealed normal coronary arteries. Finally, the diagnosis of viral myocarditis was made on consideration of his fever, scattered red dots on his arms and legs and other auxiliary examination results obtained in the following days, which were supportive of the diagnosis. The patient improved on antiviral and myocardial protection therapy and was discharged 2 weeks later. Viral myocarditis is a common disease with a variable natural history. It remains challenging for doctors to differentiate between acute myocarditis and myocardial infarction, particularly in the early stages. A diagnosis of myocarditis should be made on the basis of synthetic evaluation of the evidence, including medical history, clinical presentation and results of the available auxiliary tests, in order to provide guidelines for treatment.
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Affiliation(s)
- Tao Zhang
- Department of Orthopedics, Jinan Central Hospital, Jinan, Shandong 250013, P.R. China
| | - Wei Miao
- Department of Cardiology, Jinan Central Hospital, Jinan, Shandong 250013, P.R. China
| | - Shixuan Wang
- Beijing University Medical School, Beijing 100191, P.R. China
| | - Min Wei
- Department of Cardiology, Jinan Central Hospital, Jinan, Shandong 250013, P.R. China
| | - Guohai Su
- Department of Cardiology, Jinan Central Hospital, Jinan, Shandong 250013, P.R. China
| | - Zhenhua Li
- Department of Cardiology, Jinan Central Hospital, Jinan, Shandong 250013, P.R. China
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Recurrent Acute Nonrheumatic Streptococcal Myocarditis Mimicking STEMI in a Young Adult. Case Rep Cardiol 2014; 2014:964038. [PMID: 24963417 PMCID: PMC4055074 DOI: 10.1155/2014/964038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 05/08/2014] [Indexed: 11/17/2022] Open
Abstract
Myocarditis consists of an inflammation of the cardiac muscle, definitively diagnosed by endomyocardial biopsy. The causal agents are primarily infectious: in developed countries, viruses appear to be the main cause, whereas in developing countries rheumatic carditis, Chagas disease, and HIV are frequent causes. Furthermore, myocarditis can be indirectly induced by an infectious agent and occurs following a latency period during which antibodies are created. Typically, myocarditis observed in rheumatic fever related to group A streptococcal (GAS) infection occurs after 2- to 3-week period of latency. In other instances, myocarditis can occur within few days following a streptococcal infection; thus, it does not fit the criteria for rheumatic fever. Myocarditis classically presents as acute heart failure, and can also be manifested by tachyarrhythmia or chest pain. Likewise, GAS-related myocarditis reportedly mimics myocardial infarction (MI) with typical chest pain, electrocardiograph changes, and troponin elevation. Here we describe a case of recurrent myocarditis, 5 years apart, with clinical presentation imitating an acute MI in an otherwise healthy 37-year-old man. Both episodes occurred 3 days after GAS pharyngitis and resolved quickly following medical treatment.
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Determining the etiology of cardiac arrest. Herz 2014; 39:111. [DOI: 10.1007/s00059-013-3926-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yoshimizu N, Tominaga T, Ito T, Nishida Y, Wada Y, Sohmiya K, Tanaka S, Shibata K, Kanzaki Y, Ukimura A, Morita H, Hoshiga M, Ishizaka N. Repetitive fulminant influenza myocarditis requiring the use of circulatory assist devices. Intern Med 2014; 53:109-14. [PMID: 24429449 DOI: 10.2169/internalmedicine.53.1117] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 52-year-old man was admitted to our hospital due to shortness of breath that developed one week after the diagnosis of influenza infection. He had a past history of myocarditis associated with influenza B infection 16 years before the current admission. The patient's left ventricular function showed diffuse hypokinesis with a left ventricular ejection fraction of 28%. Due to the progression of heart failure, the infusion of catecholamines and insertion of an intra-aortic balloon pump were required. The patient was discharged uneventfully on the 23rd hospital day. A significant increase in the serum antibody titer against influenza A virus subtype H3N2 led to a diagnosis of recurrent fulminant influenza myocarditis.
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Correspondence. Am J Emerg Med 2013; 31:1613-4. [DOI: 10.1016/j.ajem.2013.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 07/22/2013] [Accepted: 07/24/2013] [Indexed: 11/23/2022] Open
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