Diagnostic utility of cardiac magnetic resonance in recurrent “third time” myocarditis without electrocardiographic changes a case report and literature review

Yusuke Sasa, Riku Arai, Nobuhiro Murata, Akimasa Yamada, Masaki Monden, Tomoyuki Morikawa, Naotaka Akutsu, Daisuke Fukamachi, Yasuo Okumura

Research output: Contribution to journalArticlepeer-review

Abstract

A few studies have reported on recurrent myocarditis occurring more than twice in one patient. In this study, we present a recurrent “third time” acute myocarditis in a young female Japanese patient with a history of a definitive diagnosis of lymphocytic myocarditis by endomyocardial biopsy, cardiac magnetic resonance imaging (CMR), and catheter examination twice in the past. Although chest pain and an increase in the cardiac enzymes were observed the third time, no significant changes were noted in the 12-lead electrocardiogram (ECG), and a definitive diagnosis could be achieved by CMR. This case suggested that in patients with a history of myocarditis, if there is chest pain and elevated cardiac enzymes even without any changes in the 12-lead ECG, acute myocarditis should be considered, and CMR is useful for the differentiation. Only four case reports including this present case were found through the previous literatures. More than two recurrent episodes of myocarditis have been extremely rare, but all cases have typical chest symptoms and a troponin level increase, leading to a relatively benign prognosis.

Original languageEnglish
Pages (from-to)1414-1419
Number of pages6
JournalInternational Heart Journal
Volume62
Issue number6
DOIs
Publication statusPublished - 2021

Keywords

  • Acute myocarditis
  • Diagnosis
  • More than two times
  • Recurrence

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