scholarly journals A Very Rare Complication of Hepatitis A Infection: Acute Myocarditis—A Case Report with Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Olivia Allen ◽  
Ahmed Edhi ◽  
Adam Hafeez ◽  
Alexandra Halalau
Keyword(s):  
Chest Pain ◽  
Ejection Fraction ◽  
Hepatitis A ◽  
Acute Myocarditis ◽  
Rare Complication ◽  
Significant Coronary Artery Disease ◽  
Kidney Injury ◽  
Maculopapular Rash ◽  
Laboratory Findings ◽  
Artery Disease

Hepatitis A is a common viral infection with a benign course but in rare cases can progress to acute liver failure. It usually presents with abdominal pain, nausea, vomiting, diarrhea, jaundice, anorexia, or asymptomatically, but it can also present atypically with relapsing hepatitis and prolonged cholestasis. In addition, extrahepatic manifestations have been reported, including urticarial and maculopapular rash, acute kidney injury, autoimmune hemolytic anemia, aplastic anemia, acute pancreatitis, mononeuritis, reactive arthritis, glomerulonephritis, cryoglobulinemia, Guillain–Barre syndrome, and pleural or pericardial effusion. A rare manifestation of hepatitis A is acute myocarditis. We report a case of a young woman who presented with “flu-like symptoms” and was found to have severe elevation of liver enzymes due to acute hepatitis A infection. On her 3rd day of admission, the patient developed chest pain and nonspecific electrocardiographic changes. Her troponins rose to 16.4  ng/mL, and a transthoracic echocardiogram revealed global hypokinesis and a depressed ejection fraction at 30%. A CT angiography showed no evidence of significant coronary artery disease. The patient was managed supportively, and symptoms and laboratory findings slowly improved over the next 7 days. Her chest pain resolved and a follow-up echocardiogram showed improved ejection fraction to 45%.

scholarly journals Escherichia coli bacteremia due to urinary tract infection complicated by acute myocarditis: A rare complication

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110236
Author(s):  
Mohamadanas Oudih ◽  
Thana Harhara
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acute Myocarditis ◽  
Rare Complication ◽  
Kidney Injury ◽  
St Segment Elevation ◽  
Infection Treatment ◽  
St Segment

Acute myocarditis is a rare complication of Escherichia coli urinary tract infection and sepsis. We report the case of a previously healthy 55-year-old female who presented to our emergency department with diarrhea and hypotension. The basic metabolic panel results showed an increase in inflammatory markers and an acute kidney injury. Urine and blood cultures grew Escherichia coli. The patient subsequently developed sudden chest pain and shortness of breath, diffuse ST-segment elevation, and cardiac enzymes’ elevation. Coronary angiogram was normal, and transthoracic echocardiogram demonstrated normal ventricular functions. Cardiac magnetic resonance imaging was highly suspicious of myopericarditis. The patient made a full recovery after infection treatment with intravenous antibiotics, aspirin, and colchicine.

scholarly journals Acute Myopericarditis Likely Secondary to Disseminated Gonococcal Infection

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Daniel Bunker ◽  
Leslie Dubin Kerr
Keyword(s):  
Chest Pain ◽  
Primary Infection ◽  
Cardiac Involvement ◽  
Acute Myocarditis ◽  
Rare Complication ◽  
Skin Lesions ◽  
Nucleic Acid Amplification ◽  
Transthoracic Echocardiogram ◽  
Gonococcal Infection ◽  
Myocardial Involvement

Disseminated gonococcal infection (DGI) is a rare complication of primary infection withNeisseria gonorrhoeae. Cardiac involvement in this condition is rare, and is usually limited to endocarditis. However, there are a number of older reports suggestive of direct myocardial involvement. We report a case of a 38-year-old male with HIV who presented with chest pain, pharyngitis, tenosynovitis, and purpuric skin lesions. Transthoracic echocardiogram showed acute biventricular dysfunction. Skin biopsy showed diplococci consistent with disseminated gonococcal infection, and treatment with ceftriaxone improved his symptoms and ejection fraction. Though gonococcal infection was never proven with culture or nucleic acid amplification testing, the clinical picture and histologic findings were highly suggestive of DGI. Clinicians should consider disseminated gonococcal infection when a patient presents with acute myocarditis, especially if there are concurrent skin and joint lesions.

scholarly journals Vulnerable personality and Takotsubo cardiomyopathy consequent to emotional stressful events: a clinical case report

2015 ◽  
Vol 76 (2) ◽  
Author(s):  
Angelo Compare ◽  
Riccardo Proietti ◽  
Domenico Del Forno ◽  
Alessandra Vitelli ◽  
Alessandra Grieco ◽  
...  
Keyword(s):  
Chest Pain ◽  
Ejection Fraction ◽  
Takotsubo Cardiomyopathy ◽  
Life Stress ◽  
Emotional Processing ◽  
Systolic Dysfunction ◽  
Significant Coronary Artery Disease ◽  
Stressful Events ◽  
Major Life ◽  
Event Scale

Introduction: Although the onset of Takotsubo cardiomyopathy (TTC) can be triggered by an acute, intense emotional stress, the exact pathogenic mechanisms still remain undefined. Presentation: A 58-year-old female was sent by ambulance to the Emergency Department (ED) for chest pain and ST elevations on ECG. Her chest pain began 3 hours before on admission after a domestic argument. Transthoracic echocardiogram showed severe systolic dysfunction with an ejection fraction of 20%. Cardiac catheterization revealed no significant coronary artery disease. The left ventriculogram showed apical ballooning with hyperdynamic proximal segments. A diagnosis of Takotsubo Cardiomyophaty (TTC) was made according to the Mayo Clinic 2008 criteria. The patient evolved with improvement of her condition and, therefore, was discharged from the hospital. Follow-up echocardiogram seven days later showed normal LV size and function with ejection fraction (EF) of 43%. Paykel Life Stress Event Scale identified as emotional trigger a domestic argument occurred 3 hours before symptom onset. History showed a major life stress event, death of a loved one, six months before symptoms. The patient underwent psychological assessment after hospital discharge by Emotional Regulation Questionnaire and BDI showing high suppression/ low reappraisal profile and moderate depression. Conclusion: This case highlights the hypothesis of a possible link between cognitive emotional processing and vulnerability to Takotsubo syndrome.

A New Integrated Clinical-Biohumoral Model to Predict Functionally Significant Coronary Artery Disease in Patients With Chronic Chest Pain

2015 ◽  
Vol 31 (6) ◽  
pp. 709-716 ◽  
Author(s):  
Chiara Caselli ◽  
Daniele Rovai ◽  
Valentina Lorenzoni ◽  
Clara Carpeggiani ◽  
Anna Teresinska ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Significant Coronary Artery Disease ◽  
Artery Disease

scholarly journals A Case of Tacotsubo Cardiomyopathy - How We Uncovered the Diagnosis

2020 ◽  
pp. 1-6
Author(s):  
V. Andova ◽  
M. Otljanska ◽  
H. Taravari ◽  
A. Jovkovski ◽  
N. Kostova ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Anticoagulation Therapy ◽  
Significant Coronary Artery Disease ◽  
Left Ventricular ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Artery Disease

Introduction: Tacotsubo cardiomyopathu (TTC) is a stress-induced condition characterized by transient appical hypokinesia and is usually caused by stress-induced catecholamine release with toxic action that leads to stunning myocardium. Methods and Results: The patient was a 62 year old woman without any history of heart disease and she admitted with chest pain and electrocardiography (ECG) with ST segment elevation in the precordial leads and troponins suggesting acute anterior myocardial infarction (MI). Emergency coronary angiography which is performed showed no significant coronary artery disease. Echocardiography showed reduced LV ejection fraction with left ventricular apical ballooning and (LV) thrombus. Cardiac magnetic resonance imaging showed localized hypokinesia of the mid septal segments and akinesis of all segments of the apex of the left ventricle and T2 hyperintesity consistent with myocardial transmural oedema in the same area with diffuse involvement. During the hospitalizasion patient was treated with single antiplatelet, anticoagulation therapy, diuretics, angiotensin-converting-enzyme inhibitors (ACE inhibitors) and beta blockers for treatment of heart failure reduced Ejection fraction (HFrEF). At 3 months follow up ECG was normal with reversal of symptoms and regression of wall motion abnormalities at echocardiography. According to investigation results, a diagnosis of tako­tsubo syndrome (TTS) was established. Conclusion: Tako-tsubo cardiomyopathy often presents as an acute coronary syndrome with ST segment changes, as ST-segment elevation and/or T-wave inversion. Clinical presentation is characterized by acute coronary artery disease, in the absence of obstruction, verified by coronarography.Diagnostic methods are very important to make true decision of Tacotsubo cardiomyopathy.

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