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Myocardial calcification found in Epstein-Barr viral myocarditis and rhabdomyolysis: A case report

Mingliang Sui1, Weibing Tang, Changjiang Wu

  • 1Department of Critical Care Medicine, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou, China.

Medicine
|December 15, 2018
PubMed

Insights

This case report describes a rare instance of myocardial calcification in a patient with Epstein-Barr (EB) viral myocarditis and rhabdomyolysis. The patient survived and recovered with intensive treatment, highlighting a potential link between EB virus and this cardiac complication.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Epstein-Barr (EB) virus is an uncommon cause of fulminant myocarditis.
  • This case is the first to report myocardial calcification in EB viral myocarditis and rhabdomyolysis.

Observation:

  • A 17-year-old male presented with fever, chest tightness, and tachypnea.
  • Initial investigations revealed elevated liver enzymes, creatine kinase, creatine kinase isoenzyme, and serum myoglobin.
  • Echocardiography demonstrated decreased left ventricular motion amplitude; EB virus antibodies were positive, confirming fulminant myocarditis, cardiogenic shock, and rhabdomyolysis.

Findings:

  • The patient received intensive treatment including venoarterial extracorporeal membrane oxygenation (VA-ECMO) and continuous renal replacement therapy (CRRT).
  • Computed tomography (CT) revealed myocardial calcification in the left ventricle walls 10 days post-admission.
  • Four months later, the patient is alive and functioning adequately in daily life.

Implications:

  • This case suggests a potential association between EB viral infection, rhabdomyolysis, and the development of myocardial calcification.
  • Highlights the importance of considering EB virus in cases of fulminant myocarditis with rhabdomyolysis and subsequent cardiac complications.
Abstract

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