[Isolated right heart failure in acute lymphocytic myocarditis]

The authors report a case of acute myocarditis, presenting with signs of isolated right heart failure which was progressive and fatal. This is a very rare observation which poses diagnostic problems. A review of the literature showed only 4 previous reports, all diagnosed at autopsy, in which the diagnosis was not suspected in vivo. In our case, echocardiography raised the possibility of myocarditis at an early stage, although the initial clinical signs were atypical and did not indicate right ventricular disease. It is particularly important to detect right ventricular involvement, especially when associated with left ventricular disease, as the prognosis is very poor. This case report illustrates the difficulty of the differential diagnosis and shows the diagnostic and prognostic value of echocardiography when interpreted in the clinical and electrocardiographic context.