[Fulminant myocarditis causing severe left heart failure and massive thrombus formation following cardiac tamponade: a case report]

J Cardiol. 2005 Jul;46(1):25-31.
[Article in Japanese]

Abstract

A woman aged middle thirties presented with common cold-like symptoms, and was hospitalized due to hypotension and tachycardia. Echocardiography revealed pericardial effusion and preserved left ventricular fractional shortening (28%). Cardiac index, pulmonary capillary wedge and right atrial pressure were 1.8 l/min/m2, 15 and 13 mmHg, respectively. After drainage of pericardial effusion, cardiac index increased to 3.4 l/min/m2. On the fifth hospital day, left ventricular dysfunction developed (fractional shortening: 16%, cardiac index: 1.5 l/min/m2, pulmonary capillary wedge pressure: 18 mmHg, right atrial pressure: 12 mmHg), so percutaneous cardiopulmonary support was introduced. However, the heart failed in asystole and the cavity was occupied by massive thrombus, probably related to heparin-induced thrombocytopenia. This case of fulminant myocarditis passed through various clinical features of heart failure. She died on the 12th hospital day.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Cardiac Tamponade / etiology*
  • Disease Progression
  • Fatal Outcome
  • Female
  • Heart Diseases / etiology*
  • Heart Failure / etiology*
  • Heparin / adverse effects
  • Humans
  • Myocarditis / complications*
  • Severity of Illness Index
  • Thrombocytopenia / complications
  • Thrombosis / etiology*
  • Ventricular Dysfunction, Left / etiology*

Substances

  • Heparin