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Published on: July 25, 2019
Isolated Atrial Myocarditis With Atrial Standstill
Christopher Mann1, Robert Schönbauer1, Michael Gottsauner-Wolf1
1Department of Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
Isolated atrial myocarditis is a rare condition causing atrial standstill and heart failure. This case demonstrates its impact on cardiac function, emphasizing the need for advanced imaging in diagnosis.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Imaging
Background:
- Myocarditis commonly affects ventricles; isolated atrial myocarditis is exceptionally rare.
- Atrial myocarditis can lead to significant conduction abnormalities, atrial standstill, and right heart failure.
Observation:
- A 35-year-old man presented with dyspnea, edema, and bradycardia post-respiratory infection.
- ECG showed atrial standstill and AV block; echocardiography revealed severe RV dysfunction and TR.
- CMR confirmed atrial enhancement and edema, with electrophysiology validating atrial standstill.
Findings:
- This case highlights isolated atrial myocarditis as a cause of atrial dysfunction.
- The condition presented with postcapillary pulmonary hypertension and prominent V waves.
- Rapid atrial fibrosis led to silent atria, confirmed by MRI and electrophysiology.
Implications:
- Comprehensive multimodality imaging is crucial for diagnosing rare atrial myocarditis.
- Understanding the pathophysiology of atrial myocarditis is vital for developing effective treatments.
- This condition can cause severe atrial dysfunction despite normal mitral valves.
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