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Fatal myopericarditis complicated with coronary vein perforation under the triple antithrombotic therapy: a case

Akihiro Takasaki1,2, Ryuji Okamoto1, Hiroko Sugimoto3

  • 1Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.

European Heart Journal. Case Reports
|June 14, 2021
PubMed

Insights

A rare case of fatal myopericarditis occurred due to coronary venous perforation during triple antithrombotic therapy. This complication, leading to cardiac tamponade, highlights the need for vigilance in patients with acute pericarditis.

Area of Science:

  • Cardiology
  • Pathology

Background:

  • Acute pericarditis is typically a benign condition.
  • Coronary vein involvement is an uncommon finding in pericarditis.

Observation:

  • A 69-year-old man developed idiopathic myopericarditis.
  • The patient was on triple antithrombotic therapy (dual antiplatelet and anticoagulant).
  • He experienced sudden cardiogenic shock and cardiac tamponade due to coronary venous perforation.

Findings:

  • Autopsy confirmed cardiac tamponade resulting from a perforated coronary vein.
  • This is the first reported case of fatal myopericarditis secondary to coronary venous perforation.

Implications:

  • Clinicians should be aware of this rare but potentially fatal complication.
  • Vigilance is crucial for patients with acute myopericarditis and bloody effusion on triple antithrombotic therapy.
Abstract

Keywords:
Case reportCoronary veinPericardial diseaseTriple antithrombotic therapy

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