Postural hypotension as the initial presentation of fulminant right ventricular myocarditis

The American Journal of Emergency Medicine
Cheng-Hsuan HoShih-Hung Tsai

Abstract

Myocarditis can be totally asymptomatic or can manifest with chest pain syndromes, ranging from mild persistent chest pain of acute myopericarditis to severe symptoms that mimic acute myocardial infarction. About 60% of patients may have antecedent arthralgias, malaise, fevers, sweats, or chills consistent with viral infections 1 to 2 weeks before onset. Here, we report a postpartum young woman who developed postural hypotension as the first manifestation of fulminant myocarditis with initially acute "cold and dry" right-sided heart failure and cardiogenic shock. Common causes of postural hypotension include volume depletion, medications, diabetes, alcohol, infection, and varicose veins as well as dysautonomic syndromes. Fulminant myocarditis can cause cardiogenic shock. Myocardial inflammation more frequently affects localized areas of the left ventricle free wall, rarely right ventricle (RV). However, predominant RV involvement with acute right-sided heart failure and low cardiac output syndrome can be easily overlooked due to lack of typical heart failure signs. On reviewing medical literatures, we had found no report regarding the RV involvement with acute right-sided heart failure as the initial presentation of fulminant m...Continue Reading

References

Jul 18, 2000·Journal of the American College of Cardiology·G M FelkerJ M Hare
Nov 13, 2001·The American Journal of Cardiology·K P ThelemanW C Roberts
Jul 28, 2004·Circulation Journal : Official Journal of the Japanese Circulation Society·Shigeru KatoHitoshi Hishida
Feb 2, 2006·Circulation·Kenneth L Baughman
Apr 1, 2006·International Journal of Cardiology·Cheng-Han LeeJyh-Hong Chen

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Citations

Nov 22, 2011·Journal of the American Society of Hypertension : JASH·Carlos Feldstein, Alan B Weder
Dec 19, 2015·Pediatric Cardiology·Fujito NumanoBeth F Printz
Nov 3, 2010·The American Journal of Emergency Medicine·James D Fett
Mar 7, 2020·Future Cardiology·Wendy YingSammy Zakaria

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