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Acute Myopericarditis with Crohn's Disease Flare-up
Manish Kumar1, Varun Tandon1, Christian M Mosebach1
1Internal Medicine, University of Connecticut, Farmington, USA.
Cureus
|May 28, 2019
Summary
Acute myopericarditis can occur during inflammatory bowel disease (IBD) flares. This case highlights cardiac inflammation during a Crohn's disease flare-up, emphasizing the need for vigilance in IBD patients.
Area of Science:
- Cardiology
- Gastroenterology
- Internal Medicine
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn's disease and ulcerative colitis, is primarily associated with gastrointestinal manifestations.
- Cardiac involvement in IBD is uncommon but recognized as a potential complication, either from the disease process or its treatments.
Observation:
- A 37-year-old male with severe Crohn's disease experienced worsening gastrointestinal symptoms, unresponsive to escalated mesalamine and steroid therapy.
- The patient subsequently developed pleuritic chest pain, with electrocardiogram findings suggestive of myocardial injury and elevated inflammatory markers (ESR, CRP).
Findings:
- Cardiac magnetic resonance imaging confirmed active myocarditis, characterized by early gadolinium enhancement.
- Treatment with colchicine and increased steroid dosage led to clinical improvement, suggesting an inflammatory etiology linked to the Crohn's flare.
Implications:
- This case underscores the importance of considering cardiac complications, such as myopericarditis, in IBD patients presenting with chest pain during disease exacerbations.
- Early recognition and appropriate management, potentially involving anti-inflammatory agents, are crucial for addressing IBD-associated cardiac events.