Myocarditis due to oral flurbiprofen use

Area of Science:

• Cardiology
• Dermatology
• Pharmacology

Background:

• Drug-induced hypersensitivity reactions can manifest with diverse clinical presentations.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like flurbiprofen are common culprits for adverse drug events.

Observation:

• A 23-year-old male presented with chest pain, skin eruptions on hands, lips, mouth, and penis, and an ulcerated penile lesion.
• Electrocardiogram revealed ST elevations, and cardiac biomarkers showed a gradual rise.
• Myocardial scintigraphy indicated hypoperfusion in the inferoseptal wall.

Findings:

• The patient's symptoms developed 10 days after initiating flurbiprofen.
• The clinical presentation and diagnostic findings are consistent with a rare case of drug-induced myocarditis.
• The myocarditis was attributed to a hypersensitivity reaction to flurbiprofen.

Implications:

• Drug-induced myocarditis should be considered in the differential diagnosis of patients presenting with nonspecific angina pectoris and electrocardiogram abnormalities.
• Early recognition and withdrawal of the offending drug are crucial for managing hypersensitivity reactions.
• This case underscores the need for vigilance regarding potential cardiac complications of NSAID use.