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Myocarditis combined with hypertrophic cardiomyopathy: a case report

Jing-Yue Wang1, Yu-Shi Wang1, Bo-Tao Shen1

  • 1Department of Cardiology, The First Hospital of Jilin University, Changchun, China.

Annals of Palliative Medicine
|May 28, 2021
PubMed

Insights

Persistent ventricular wall thickening in myocarditis patients may indicate coexisting hypertrophic cardiomyopathy (HCM). Early identification of this combination is crucial for appropriate patient management and treatment strategies.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Genetics

Background:

  • Myocarditis, an inflammation of the heart muscle, can lead to ventricular wall thickening due to edema.
  • Persistent ventricular wall thickening, even after acute inflammation subsides, suggests an underlying condition.
  • Hypertrophic cardiomyopathy (HCM) is a genetic heart condition characterized by abnormal thickening of the heart muscle.

Observation:

  • A 30-year-old male presented with chest pain, sweating, and fever, initially improving with self-medication.
  • ECG showed ST-segment elevation and ST-T wave changes; cardiac troponin I was markedly elevated.
  • Echocardiography revealed significant interventricular septum thickening (17 mm) and left ventricular hypokinesia, without outflow tract obstruction.

Findings:

  • Laboratory tests were negative for respiratory infections but positive for IgG antibodies against herpes simplex virus (HSV), rubella virus (RV), and cytomegalovirus (CMV).
  • The patient was diagnosed with myocarditis coexisting with hypertrophic cardiomyopathy (HCM).
  • Persistent ventricular wall thickening in the context of myocarditis is a key indicator for considering concomitant HCM.

Implications:

  • This case highlights the importance of considering hypertrophic cardiomyopathy (HCM) in patients with myocarditis presenting with persistent ventricular wall thickening.
  • Prompt diagnosis and management of combined myocarditis and HCM are essential to prevent adverse cardiovascular outcomes.
  • Further research into the interplay between viral infections and genetic predispositions in developing combined cardiac conditions is warranted.

Keywords:
Hypertrophic cardiomyopathy (HCM)case reportdiffuse left ventricular hypokinesis (LV hypokinesis)interventricular septummyocarditis

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