scholarly journals Acute necrotizing eosinophilic myocarditis possibly triggered by an antimigraine drug as an uncommon cause of acute heart failure: a case report

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Luís Beck-da-Silva ◽  
Alexandre Maulaz ◽  
Paulo Schvartzman ◽  
Francine Hehn Oliveira ◽  
Jonathas Stifft ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Wide Spectrum ◽  
Acute Myocarditis ◽  
Central Nervous System Vasculitis ◽  
Case Summary ◽  
Acute Necrotizing ◽  
Systemic Hypersensitivity ◽  
Eosinophilic Myocarditis ◽  
Electrocardiogram Ecg ◽  
Rule Out

Abstract Background Epigastric or chest pain with an abnormal electrocardiogram (ECG) in a young, otherwise healthy patient should trigger an investigation to rule out myocarditis. The myocarditis covers a wide spectrum of severity. The search for the aetiologic factor could be definitive for the success of therapy. Case summary A previously healthy 29-year-old woman presented to the Emergency Room with epigastric pain, eosinophilia, and an abnormal ECG. A thorough evaluation including cardiac magnetic resonance and endomyocardial biopsy was undertaken. A diagnosis of acute necrotizing eosinophilic myocarditis was made. Discussion The case is particularly unique for its suspected predisposing trigger: an antimigraine drug. A possible systemic hypersensitivity reaction, reflected by the occurrence of concomitant severe serum eosinophilia, acute myocarditis, and central nervous system vasculitis, was successfully treated with steroids, further supporting the diagnosis.

Fatal Acute Necrotizing Eosinophilic Myocarditis during Peripartum: Case Report

2016 ◽  
Vol 01 (03) ◽  
Author(s):  
Santa Carbonara ◽  
Marco Matteo Ciccone ◽  
Pietro Scicchitano ◽  
Massimo Colonna ◽  
Eloisa Maselli ◽  
...  
Keyword(s):  
Case Report ◽  
Acute Necrotizing ◽  
Eosinophilic Myocarditis

Branch Retinal Artery Occlusion Following Intravitreal Injection of Methotrexate for the Treatment of Primary Vitreoretinal Lymphoma

2019 ◽  
Vol 3 (6) ◽  
pp. 485-487
Author(s):  
Arthi G. Venkat ◽  
Naveen Karthik ◽  
Ashley Lowe ◽  
Sumit Sharma
Keyword(s):  
Intravitreal Injection ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Branch Retinal Artery Occlusion ◽  
Primary Vitreoretinal Lymphoma ◽  
Case Summary ◽  
Vitreoretinal Lymphoma ◽  
Retinal Artery ◽  
Vitreous Biopsy ◽  
Rule Out

Purpose: This paper reports a case of an older white woman presenting with recalcitrant bilateral vitreoretinal inflammation that was ultimately proven to be primary vitreoretinal lymphoma by vitreous biopsy who subsequently developed a branch retinal artery occlusion (BRAO) following an intravitreal injection of methotrexate. Methods: Case summary. Results: The patient was treated with serial intravitreal methotrexate injections and subsequently developed a BRAO immediately following her seventh injection. Conclusions: A full systemic evaluation to rule out other causes of the BRAO was negative and given the timing of her symptoms after the injection it was determined that the BRAO was most likely realted to the intravitreal methotrexate injection.

Acute necrotizing eosinophilic myocarditis presented as an acute coronary syndrome

2020 ◽  
Author(s):  
Clothilde Berger ◽  
Sara Boccalini ◽  
Anne Champagnac ◽  
Michel Ovize ◽  
Thomas Bochaton
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Syndrome ◽  
Acute Necrotizing ◽  
Eosinophilic Myocarditis

scholarly journals Acute Necrotizing Eosinophilic Myocarditis Successfully Treated by High Dose Methylprednisolone

2001 ◽  
Vol 65 (10) ◽  
pp. 923-926 ◽  
Author(s):  
Nozomi Watanabe ◽  
Susumu Nakagawa ◽  
Takashi Fukunaga ◽  
Shuji Fukuoka ◽  
Kinta Hatakeyama ◽  
...  
Keyword(s):  
High Dose ◽  
High Dose Methylprednisolone ◽  
Acute Necrotizing ◽  
Eosinophilic Myocarditis

Fatal Acute Necrotizing Eosinophilic Myocarditis Temporally Related to Use of Adalimumab in a Patient With Relapsing Polychondritis

2013 ◽  
Vol 19 (7) ◽  
pp. 386-389 ◽  
Author(s):  
Rosemary Adamson ◽  
Yusuf Yazici ◽  
Edward S. Katz ◽  
Stewart G. Greisman ◽  
David Steiger
Keyword(s):  
Relapsing Polychondritis ◽  
Acute Necrotizing ◽  
Eosinophilic Myocarditis

scholarly journals Immediate Rule-Out of Acute Myocardial Infarction Using Electrocardiogram and Baseline High-Sensitivity Troponin I

2017 ◽  
Vol 63 (1) ◽  
pp. 394-402 ◽  
Author(s):  
Johannes Tobias Neumann ◽  
Nils Arne Sörensen ◽  
Francisco Ojeda ◽  
Tjark Schwemer ◽  
Jonas Lehmacher ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Troponin I ◽  
High Sensitivity ◽  
Low Risk ◽  
High Sensitivity Troponin ◽  
Testing Trial ◽  
Pain Symptoms ◽  
Electrocardiogram Ecg ◽  
Rule Out

Abstract AIMS Serial measurements of high-sensitivity troponin are used to rule out acute myocardial infarction (AMI) with an assay specific cutoff at the 99th percentile. Here, we evaluated the performance of a single admission troponin with a lower cutoff combined with a low risk electrocardiogram (ECG) to rule out AMI. METHODS Troponin I measured with a high-sensitivity assay (hs-TnI) was determined at admission in 1040 patients presenting with suspected AMI (BACC study). To rule out AMI we calculated the negative predictive value (NPV) utilizing the optimal hs-TnI cutoff combined with a low risk ECG. The results were validated in 3566 patients with suspected AMI [2-h Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker (ADAPT) studies]. Patients were followed for 6 or 12 months. RESULTS 184 of all patients were diagnosed with AMI. An hs-TnI cutoff of 3 ng/L resulted in a NPV of 99.3% (CI 97.3–100.0), ruling out 35% of all non-AMI patients. Adding the information of a low risk ECG resulted in a 100% (CI 97.5–100.0) NPV (28% ruled out). The 2 validation cohorts replicated the high NPV of this approach. The follow-up mortality in the ruled out population was low (0 deaths in BACC and Stenocardia, 1 death in ADAPT). CONCLUSIONS A single hs-TnI measurement on admission combined with a low risk ECG appears to rule out AMI safely without need for serial troponin testing. Trial Registration: www.clinicaltrials.gov (NCT02355457).

Digoxin Toxicity Secondary to Clarithromycin Therapy

1997 ◽  
Vol 31 (7-8) ◽  
pp. 864-866 ◽  
Author(s):  
James J. Nawarskas ◽  
David M. McCarthy ◽  
Sarah A. Spinier
Keyword(s):  
Digoxin Concentration ◽  
Serum Digoxin Concentration ◽  
Digoxin Toxicity ◽  
Case Summary ◽  
Serum Digoxin ◽  
St Segment ◽  
Digoxin Bioavailability ◽  
Electrocardiogram Ecg ◽  
Ecg Abnormalities ◽  
Digoxin Therapy

OBJECTIVE: To report a case of digoxin toxicity thought to be secondary to clarithromycin therapy. CASE SUMMARY: A 78-year-old white woman with congestive heart failure taking digoxin 0.25 mg po qd presented to our hospital with nausea, vomiting, and diarrhea. She had taken clarithromycin 500 mg po bid for 3 days, and a serum digoxin concentration obtained the day of admission was 4.4 μg/L. An electrocardiogram (ECG) done on admission revealed ST segment changes consistent with digoxin effect and later asymptomatic, nonsustained ventricular tachycardia (NSVT). Clarithromycin was discontinued and digoxin was withheld at admission, resulting in the resolution of symptoms, ECG abnormalities, and NSVT on day 3 of hospitalization. On day 5 her serum digoxin concentration was 1.5 μg/L and digoxin therapy was reinstituted at a dose of 0.125 mg/d po. DISCUSSION: This is the fourth published case implicating clarithromycin as the cause of digoxin toxicity. This interaction is most likely due to clarithromycin eradication of digoxinmetabolizing gut flora, thereby increasing digoxin bioavailability. CONCLUSIONS: Approximately 10% of patients are thought to be extensive presystemic metabolizers of digoxin and may therefore be most susceptible to a drug interaction with clarithromycin. Serum digoxin concentrations in such patients should be monitored closely during clarithromycin therapy.

scholarly journals Use of Emergency Department Extracorporeal Membrane Oxygenation for Treatment of Acute Necrotizing Myocarditis

2019 ◽  
Vol 3 (1) ◽  
pp. 47-50
Author(s):  
Carly Loner ◽  
Peter Crane
Keyword(s):  
Emergency Department ◽  
Extracorporeal Membrane Oxygenation ◽  
Rare Complication ◽  
High Morbidity ◽  
Membrane Oxygenation ◽  
Acute Necrotizing ◽  
History Of ◽  
Eosinophilic Myocarditis ◽  
Systemic Symptoms

We report a case of acute necrotizing eosinophilic myocarditis (ANEM) secondary to drug rash with eosinophilia and systemic symptoms (DRESS) related to administration of minocycline. Myocarditis is a rare complication of DRESS and can manifest as either a self-limited hypersensitivity myocarditis or as the frequently fatal ANEM. Due to the high morbidity and mortality caused by this disease, emergency physicians should be aware of the potential of ANEM in patients with history of DRESS and new-onset cardiac dysfunction. This case reviews the clinical presentation and management of ANEM and the potential role of extracorporeal membrane oxygenation use in the emergency department.

scholarly journals Acute necrotizing eosinophilic myocarditis in a young woman

2012 ◽  
Vol 75 (10) ◽  
pp. 536-538
Author(s):  
Ying-Chieh Liao ◽  
Chieh-Shou Su ◽  
Chieh-Lin Teng ◽  
Kuo-Yang Wang ◽  
Fang-Yi Lin ◽  
...  
Keyword(s):  
Young Woman ◽  
Acute Necrotizing ◽  
Eosinophilic Myocarditis
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