ABSTRACT
INTRODUCTION: The etiology of myocarditis often remains undetermined. A large variety of infectious agents, systemic diseases, drugs, and toxins can cause the disease. We report the case of a 19-year-old man who developed myocarditis three days after Pfizer-BioNTech COVID-19 booster vaccination. CASE REPORT: A 19-year-old man, presenting with troponin-positive acute chest pain, was referred to our department. He had received the Pfizer-BioNTech COVID-19 vaccine three days prior to his admission. The diagnosis of acute myocarditis was confirmed by cardiovascular magnetic resonance imaging. Patient hemodynamic status remained stable during hospitalization. The left ventricular ejection fraction was preserved during hospital stay and at one-month follow-up. We found no evidence for another infectious or autoimmune etiology. CONCLUSION: Although imputability of the vaccine cannot be formally established on the basis of this case report, the findings raise the possibility of an association between mRNA COVID-19 vaccination and acute myocarditis.
Subject(s)
COVID-19 , Myocarditis , Adult , BNT162 Vaccine , COVID-19 Vaccines , Humans , Male , Myocarditis/chemically induced , Myocarditis/diagnosis , SARS-CoV-2 , Stroke Volume , Vaccination/adverse effects , Ventricular Function, Left , Young AdultABSTRACT
Particularities of African descent patient's electrocardiogram have been described for many years. Variations such as higher QRS voltage, early repolarization pattern, precordial T-wave inversion and anterior ST segment elevation associated with T-wave inversion are more frequently observed. Ignorance of these variations can lead to misdiagnosis or therapeutic negligence. We present the electrocardiographic particularities attributed to the patient of African origin.
Subject(s)
Black People , Electrocardiography , Heart Diseases/diagnosis , Heart Diseases/physiopathology , Heart/physiopathology , Africa , HumansABSTRACT
INTRODUCTION: Interactions between heart and thyroid are strong. Main cardiac complications of Graves' disease are supra-ventricular tachycardia or high output cardiac failure, without real myocardial involvement. OBSERVATION: A 40-year-old man with history of refractory Graves' disease was hospitalized for an acute chest pain with elevated cardiac biomarkers and normal coronarography. Acute myocarditis was confirmed by cardiac MRI. We found no evidence for an infectious etiology. We retained the hypothesis of acute autoimmune myocarditis in the context of active Graves' disease. CONCLUSION: Acute myocarditis is an exceptional complication of Graves' disease, with most likely an autoimmune mechanism. Possible occurrence of fulminant rhythmic or hemodynamic complications justify minimal cardiological check-up before introducing beta blockers.
Subject(s)
Autoimmune Diseases/etiology , Graves Disease/complications , Myocarditis/etiology , Acute Disease , Adult , Autoimmune Diseases/diagnosis , Chest Pain/diagnosis , Chest Pain/etiology , Graves Disease/diagnosis , Graves Disease/immunology , Humans , Male , Myocarditis/diagnosis , Myocarditis/immunologyABSTRACT
Doping is the use of a substance that artificially increases an individual's physical ability for competition purpose. Products and methods used in doping are not without risk, especially at cardiovascular level. Here we review the most common doping substances in sport and their cardiovascular consequences.
Subject(s)
Cardiovascular Diseases/chemically induced , Doping in Sports , Adrenergic beta-2 Receptor Antagonists/adverse effects , Anabolic Agents/adverse effects , Blood Transfusion, Autologous/adverse effects , Cannabinoids/adverse effects , Cardiovascular Diseases/prevention & control , Central Nervous System Stimulants/adverse effects , Diuretics/adverse effects , Erythropoietin/adverse effects , Glucocorticoids/adverse effects , Hormone Antagonists/adverse effects , HumansABSTRACT
Kounis syndrome is an allergic acute coronary syndrome. It occurs on healthy or pathological arteries. Its complications, although often benign, can lead to cardiac arrest and death. Its triggering factors are multiple and include contrast products used in diagnostic imaging. We report the case of an 81 years old patient affected by hepatocellular carcinoma, who presented a type 2 Kounis syndrome with inferior myocardial infarction, complicated by cardiac arrest related to complete heart block following a gadoteric acid injection.
Subject(s)
Atrioventricular Block/etiology , Contrast Media/adverse effects , Heart Arrest/etiology , Inferior Wall Myocardial Infarction/complications , Kounis Syndrome/etiology , Meglumine/adverse effects , Organometallic Compounds/adverse effects , Aged, 80 and over , Contrast Media/administration & dosage , Humans , Injections , Male , Meglumine/administration & dosage , Organometallic Compounds/administration & dosageABSTRACT
BACKGROUND: Real life management of myocardial infarction has not recently been evaluated in France. AIMS: To describe ST-elevation myocardial infarction management in France in 2014 and to compare it with current guidelines. METHODS: A multicentre study was performed. An e-mail questionnaire was sent to French interventional cardiologists. Demographic data of interventional cardiologists, procedural aspects of percutaneous coronary intervention, antithrombotic treatments and patient rehabilitation have been investigated. RESULTS: One hundred and seventy-six answers were analysed. Most of centres realized more than 600 annual angioplasties. An average of 209 myocardial infarctions were managed per centre in 2014, more often in academic than in general or private centres (respectively 51, 32 and 17% of infarctions). Anti-GPIIbIIIa (34% of the cases) and thromboaspiration were not systematic but depend on patient's characteristics, according to guidelines. Radial access was favoured in 85% of the cases and increased for the last decade. Drug eluting stents were used in 62% of cases. Unfractionated heparin and enoxaparine accounted for more than 80% of anticoagulants treatments. Overall, use of clopidogrel was as high as that of prasugrel or ticagrelor although clopidogrel is recommended in second-line. Cardiovascular rehabilitation was proposed to more than 50% of patients. CONCLUSION: In spite of heterogeneity of ST-elevation myocardial infarction management in 2014, real-life practices generally comply with current guidelines.
Subject(s)
Cardiology , Practice Patterns, Physicians' , ST Elevation Myocardial Infarction/therapy , France , Health Care Surveys , Humans , Practice Guidelines as TopicABSTRACT
AIMS: Despite diagnostic and therapeutic advances, infective endocarditis (IE) remains a severe disease. The aim of the study was to describe clinical features and prognosis of patients with IE in a non-teaching hospital and compare them with current data and a similar study conducted 10 years earlier in the same center. METHODS: We performed a single institution retrospective study including all patients with Duke-Li definite IE between 2004 and 2014. RESULTS: Ninety-four patients were included. Results are consistent with current French and international data, including in-hospital death rate of 16%. In accordance with literature, we report on an increase in Staphylococcus and health care-associated IE and endocarditis on pacemaker leads, but without significant difference compared to our previous study. In univariate analyses, renal failure, age over 77 years and Staphylococcus aureus IE were associated with in-hospital mortality. In multivariate analyses, predictors of in-hospital death were renal failure and lack of surgery. There was a non-significant trend of excess mortality in Staphylococcus endocarditis and in patients with heart failure. CONCLUSION: IE remains a severe disease and S. aureus is more often involved. IE seems to be safely managed in a peripheral hospital provided that there is a partnership with a reference hospital.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Endocarditis/diagnosis , Endocarditis/drug therapy , Staphylococcal Infections/complications , Staphylococcal Infections/drug therapy , Aged , Aged, 80 and over , Echocardiography/methods , Echocardiography, Transesophageal/methods , Endocarditis/microbiology , Endocarditis/mortality , Female , Hospitals, General , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors , Staphylococcal Infections/diagnosis , Staphylococcal Infections/mortality , Staphylococcus aureus/isolation & purification , Treatment OutcomeABSTRACT
INTRODUCTION: Antiphospholipid syndrome is an autoimmune disorder causing venous and arterial thrombosis. Acute coronary complications are rare but potentially dramatic. CASE REPORT: We report a 39-year-old woman who presented with an acute anterior myocardial infarction after intravenous corticosteroids as part of the treatment of lupus arthritis and revealing antiphospholipid syndrome. Emergency coronary angiography was performed with drug-eluting stent angioplasty despite the need for anticoagulation and dual antiplatelet therapy. CONCLUSION: Antiplatelet and anticoagulant therapy management is pivotal in patients with antiphospholipid syndrome and acute coronary syndrome to prevent thrombosis recurrence.
Subject(s)
Antiphospholipid Syndrome/diagnosis , Antiphospholipid Syndrome/etiology , Arthritis/etiology , Lupus Erythematosus, Systemic/complications , Myocardial Infarction/etiology , Adult , Anticoagulants/therapeutic use , Arthritis/diagnosis , Arthritis/drug therapy , Coronary Angiography , Diagnosis, Differential , Female , Humans , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/drug therapy , Myocardial Infarction/diagnosis , Percutaneous Coronary InterventionABSTRACT
Carbon monoxide poisoning is the leading cause of death by poisoning in France. Neuropsychological symptoms are most common. We report on a patient with acute coronary syndrome and transient left ventricular dysfunction in carbon monoxide poisoning. Patient improved under hyperbaric oxygen therapy. Coronary angiography shows no significant lesion leading to myocardial stunning diagnose. Patients exposed to carbon monoxide must have systematic cardiac evaluation with electrocardiogram and dosage of biomarkers.
Subject(s)
Acute Coronary Syndrome/etiology , Carbon Monoxide Poisoning/complications , Ventricular Dysfunction, Left/etiology , Humans , Male , Middle AgedABSTRACT
Cardiac allograft vasculopathy is the major determinant of long-term survival in patients after heart transplantation. Clinical presentations are congestive heart failure, ventricular arrhythmias and sudden cardiac death. Acute coronary syndrome is a rare presentation of cardiac allograft vasculopathy due to myocardial denervation. We present the case of a 31-year-old patient, who had undergone heart transplantation 6 months earlier and who developed a painless anterior myocardial infarction revealed by syncope. He was successfully treated by percutaneous coronary intervention with drug eluting stent implantation.
Subject(s)
Anterior Wall Myocardial Infarction , Heart Transplantation , Postoperative Complications , Adult , Anterior Wall Myocardial Infarction/diagnosis , Anterior Wall Myocardial Infarction/therapy , Humans , Male , Postoperative Complications/diagnosis , Postoperative Complications/therapyABSTRACT
Coronary artery (CA) dissection following blunt chest trauma is a life-threatening and rare event. Its occurrence in the setting of a contact sport like rugby is even less common. We report on two cases of young adult presenting with segment elevation myocardial infarction related to CA dissection following rugby game. Both were successfully treated with stent implantation. We discuss the mechanism, diagnosis, and optimal management of blunt chest trauma-induced CA dissection.
Subject(s)
Echocardiography/methods , Hemorrhagic Fever, Ebola/diagnostic imaging , Myocarditis/diagnostic imaging , Adult , Ebolavirus , Echocardiography/adverse effects , Feasibility Studies , Female , Guinea , Hemorrhagic Fever, Ebola/complications , Humans , Male , Middle Aged , Military Personnel , Myocarditis/etiologyABSTRACT
We report on a patient hospitalized in cardiology department to explore dyspnea and right ventricular failure evoking constrictive pericarditis. This case is of great interest to review conventional and new imaging features used for the diagnosis of constrictive pericarditis versus restrictive cardiomyopathy.
Subject(s)
Pericarditis, Constrictive/diagnosis , Cardiac Catheterization/methods , Diagnosis, Differential , Echocardiography/methods , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Pericarditis, Constrictive/diagnostic imaging , Pericarditis, Constrictive/surgery , Radiography , Treatment OutcomeABSTRACT
We report on two patients hospitalized in intensive care unit for ischemic strokes presenting the feature of marantic endocarditis complicating lung's adenocarcinoma. These two cases turned out to be very interesting because of the occurrence of ischemic strokes even though the patients were receiving the recommended treatment, namely anticoagulation with heparin, in well-adjusted doses. The management of nonbacterial thrombotic endocarditis remains a challenge and its mortality is still high.
Subject(s)
Brain Ischemia/etiology , Endocarditis, Non-Infective/complications , Endocarditis, Non-Infective/diagnosis , Stroke/etiology , Aged , Anticoagulants/therapeutic use , Brain Ischemia/prevention & control , Female , Heparin/therapeutic use , Humans , Male , Middle Aged , Stroke/prevention & control , Treatment FailureABSTRACT
We report the case of a 63-year old patient presenting five infective endocarditis (IE) in a 13-years period, with different types of streptococcus. No entrance way had been found until the last relapse occurring on mitro-aortic bioprosthesis. This recurrence leads to the diagnosis of caecal adenocarcinoma by coloscopy, preceded and guided by PET scanner. It seems to be the initial entrance way which had been unrecognized because of its small size and its particular location, that is very difficult to observe by coloscopy. Recurrent streptococcus IE are rare and severe. When a gut or colic tumor is suspected, PET scan seems to be helpful in etiological survey.
Subject(s)
Adenocarcinoma/diagnosis , Cecal Neoplasms/diagnosis , Endocarditis, Bacterial/diagnosis , Enterococcus faecalis , Gram-Positive Bacterial Infections/diagnosis , Opportunistic Infections/diagnosis , Streptococcal Infections/diagnosis , Streptococcus bovis , Streptococcus oralis , Anti-Bacterial Agents/therapeutic use , Bioprosthesis/microbiology , Colonoscopy , Endocarditis, Bacterial/drug therapy , Fluorodeoxyglucose F18 , Gram-Positive Bacterial Infections/drug therapy , Heart Valve Prosthesis/microbiology , Humans , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Magnetic Resonance Imaging , Male , Middle Aged , Opportunistic Infections/surgery , Positron-Emission Tomography , Recurrence , Streptococcal Infections/drug therapyABSTRACT
We report a 75-year-old woman with a severe and symptomatic valvular tricuspid dysfunction, revealing a carcinoid syndrome, confirmed by an octreotid scan and liver biopsy. Carcinoid heart disease is a common complication of carcinoid syndrome associated with poor prognosis. Despite new pharmacological treatment, valve replacement surgery is the only curative treatment. Early diagnosis and multidisciplinary management could improve prognosis and quality of life of these patients.
