Uncommon ascaris induced eosinophilic myocarditis simulating acute coronary syndrome without ST segment elevation: A case report.

Introduction: and importance: Ascaris lumbricoides is a nematode parasite that causes ascariasis. Cardiac involvement in ascariasis is uncommon and rarely reported in the literature. Case presentation: We present the case of 45 years-old man, with previous medical history of ascaris infection one week before his admission to the emergency department for acute chest pain. The electrocardiogram revealed ST-segment and T wave abnormalities in septo-apico-lateral and inferior leads, along with high levels of troponin T and eosinophil blood cells count, while transthoracic echocardiography showed lateral and inferior walls motion abnormalities. The diagnosis of myocardial infarction was made and an urgent coronary angiography was carried out revealing normal coronary arteries which redressed the diagnosis and supported ascaris induced eosinophilic myocarditis (EM). The patient was put under anthelmintic drugs with favorable clinical, biological and imaging evolution. Clinical discussion: Eosinophilic myocarditis may present with variable and misleading scenarios ranging from asymptomatic patients to cardiogenic choc and sudden death and in some cases with clinical presentation of acute coronary syndrome. Conclusion: The aim of this work was to increase recognition of EM in the light of this clinical case report of ascaris lumbricoides associated myocarditis simulating an acute coronary syndrome without ST segment elevation.

Acute double coronary occlusion and its misleading presentation: An unusual case report.

Acute simultaneous double coronary occlusion is an extremely rare condition with an unspecific presentation. We report a case of a 57-year-old male, with undiagnosed diabetes mellitus, presenting with acute epigastralgia and vomiting associated with dynamic electrocardiographic changes. He was hemodynamically stable. Emergency coronary angiogram showed a total occlusion of both proximal left circumflex and mid left anterior descending coronary artery. Since the EKG indicated minimal ST-segment elevation in the lateral leads as well as an ST depression in the inferior leads, we performed a percutaneous coronary intervention of both the LCx and LAD, using a floppy guidewire. Similar cases of multiple simultaneous coronary occlusions are reported in literature, yet the accurate incidence and physiopathology of this occurrence is still uncertain. Although this condition is associated with serious complications, our case evolved favorably due to prompt management.

[Infectious mitroaortic endocarditis complicated by valve perforation, mycotic aneurysm and splenorenal infarction]. / Endocardite infectieuse mitro-aortique compliquée de perforation valvulaire, d'anévrisme mycotique et d'infarctus spleno-rénal.

Infectious endocarditis is regarded as a potentially serious pathology despite the advances in diagnostic and treatment options. Valves on the left side of the heart are most affected and embolic events, mycotic aneurysms, abscesses as well as valve perforations are life-threatening consequences of this disease. We here report a case of endocarditis with aortic and mitral valve involvement complicated by splenic and renal infarction, cerebral mycotic aneurysm and mitral valve perforation. The interest in the subject of this case study is the positive medico-surgical treatment outcome obtained despite a multitude of complications.

[Acute coronary syndrome with ST-segment elevation revealing acute myocarditis in a young patient with normal coronaries]. / Syndrome coronaire aigu avec sus-décalage du segment ST chez un jeune à coronaires saines révélant une myocardite aigue.

Acute coronary syndromes may occur in young adults and have a non-atheromatous origin. We report the case of a young man admitted with acute coronary artery disease with systematic ST-segment elevation. Coronarography showed no abnormality and MRI confirmed acute myocarditis. Outcome was favorable under medical treatment.