ABSTRACT
Myocarditis is inflammation of cardiac muscle, which may be acute, subacute, or chronic with either focal or diffuse involvement of the myocardium. This leads to a cardiomyopathy with clinical features of heart failure as well as echocardiographic evidence of global dilation of the cardiac chambers. There are numerous reports in the literature of viral myocarditis causing dilated cardiomyopathy; however, there are no reports of recurrent viral myocarditis and vaccine-associated myocarditis in a single patient with complete reversal of the cardiomyopathy and return to normal cardiac function. We present a case of recurrent myocarditis in a female patient caused by a viral upper respiratory infection and streptococcal pneumonia vaccination who presented with recurrent episodes of reversible cardiomyopathy.
Subject(s)
Cardiomyopathy, Dilated/etiology , Myocarditis/diagnosis , Myocarditis/etiology , Aged , Cardiomyopathy, Dilated/diagnosis , Cardiomyopathy, Dilated/physiopathology , Female , Humans , Influenza Vaccines , Myocarditis/complications , Myocarditis/virology , Pneumococcal Vaccines/adverse effects , Recurrence , Respiratory Tract Infections/complicationsABSTRACT
A coronary artery aneurysm is defined as coronary dilatation that exceeds the diameter of normal adjacent artery segments, or is 1.5 times the diameter of the largest coronary artery. Coronary artery aneurysms are rare with an incidence of between 1.5% to 5%. The aneurysm is caused by destruction of the vessel media, thinning of the arterial wall, increased wall stress, and progressive dilatation of a segment of the coronary artery. The most common cause is atherosclerotic coronary artery disease. These aneurysms occasionally rupture but more commonly develop thrombus and hematoma leading to the appearance of the presence of an intramyocardial mass. We present the case of a 60-year-old man with hypertension who presented with a mass that was identified initially by transthoracic echocardiography in the setting of an inferior wall myocardial infarction, which was later recognized to be a thrombosed right coronary artery aneurysm.
Subject(s)
Coronary Aneurysm/diagnostic imaging , Heart Neoplasms/diagnostic imaging , Thromboembolism/diagnostic imaging , Coronary Vessels/diagnostic imaging , Coronary Vessels/pathology , Diagnosis, Differential , Humans , Male , Middle Aged , UltrasonographyABSTRACT
Myocardial contrast echocardiography (MCE) has been used with increasing frequency and is considered a safe way to improve left ventricular border opacification. Studies have consistently documented that MCE can improve the ability to assess both global and regional left ventricular function by echocardiography. We report the case of an 83-year-old female who developed immediate and sustained hemodynamic instability after the injection of Perflutren for a contrast echocardiogram. We reviewed the literature and found no such previous reactions with Perflutren. Based on the temporal sequence of hypotension following Perflutren injection along with other clinical data, we concluded that our patient's hemodynamic instability was most likely secondary to an anaphylactic reaction.
Subject(s)
Contrast Media/adverse effects , Echocardiography , Fluorocarbons/adverse effects , Hemodynamics/drug effects , Aged, 80 and over , Anaphylaxis/chemically induced , Contrast Media/administration & dosage , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/microbiology , Female , Fluorocarbons/administration & dosage , Humans , Infusions, Intravenous , Staphylococcal Infections/diagnosis , Staphylococcal Infections/microbiologyABSTRACT
This report describes a case of a 31-year-old woman with mitral valve endocarditis complicated by a septic embolus to a coronary artery.
