[Fulminant myocarditis].

Abstract

A 46-year-old woman was admitted due to diplopia because of ophthalmoplegia, which improved with corticosteroid therapy. Eight days later, she was admitted with fulminant myocarditis in cardiogenic shock, with severe left ventricular dysfunction and frequent episodes of nonsustained ventricular tachycardia. As there was no clinical improvement, an endomyocardial biopsy was performed that revealed inflammatory infiltrate, vasculitis, and PCR positive for cytomegalovirus, Epstein-Barr virus, parvovirus B19 and enterovirus. Left ventricular function recovered with heart failure treatment and corticosteroids. Three months later, after progressive withdrawal of prednisolone, there was recurrence of myocarditis and left ventricular dysfunction, which was successfully treated by restarting corticosteroid therapy. One month later she was readmitted with fulminant myocarditis which again responded to steroids. She intermittently presented cutaneous purpura lesions. At this time the provisional diagnosis was vasculitis and she started monthly cycles of cyclophosphamide. Before the second cycle she was admitted with pneumonia and ventricular dysfunction and died.

• Authors: Ricardo Faria, Salomé Pereira, Walter Santos, Nuno Marques, Fátima Franco, Pedro Sousa, Jorge Mimoso, Vasco Marques, Luís A Providência, Ilídio de Jesus
• Journal: Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology (Rev Port Cardiol) 2012 Jul-Aug Vol. 31 Issue 7-8 Pg. 503-7 ISSN: 0870-2551 [Print] Portugal
• Vernacular Title: Miocardite fulminante - a propósito de um caso clínico.
• PMID: 22717293 (Publication Type: Case Reports, English Abstract, Journal Article)
• Copyright: Copyright © 2011 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Topics

• Fatal Outcome
• Female
• Humans
• Middle Aged
• Myocarditis (diagnosis, drug therapy)