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Fulminant giant cell myocarditis and cardiogenic shock: an unusual presentation of malignant thymoma.

Koul D, Kanwar M, Jefic D, Kolluru A, Singh T, Dhar S, Kumar P, Cohen G - Cardiol Res Pract (2010)

Bottom Line: Malignant thymoma is rarely associated with giant cell myocarditis.We present a case study that illustrates this association and cardiogenic shock with underlying tamponade.The dramatic presentation of this scenario has not been previously described.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Cardiac Cath Laboratory, St. John Hospital and Medical Center, 22101 Moross Road, 2nd Floor VEP, Detroit, MI 48236, USA.

ABSTRACT
Malignant thymoma is rarely associated with giant cell myocarditis. We present a case study that illustrates this association and cardiogenic shock with underlying tamponade. The dramatic presentation of this scenario has not been previously described.

No MeSH data available.


Related in: MedlinePlus

Electrocardiogram showing ST segment elevation in leads I, aVL, and V2–V6.
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Related In: Results  -  Collection


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fig1: Electrocardiogram showing ST segment elevation in leads I, aVL, and V2–V6.

Mentions: A previously healthy 55-year-old woman presented with one-week history of worsening muscle weakness, diplopia, and exertional dyspnea. Physical examination revealed a pale thin female with tachycardia (107 beats/minute), tachypnea (22 breaths/minute), hypotension (blood pressure 86/50 mmHg), jugular venous distension with rapid “×” descent, and distant heart sounds. While the patient was being evaluated in the emergency room, she suddenly had a cardiopulmonary arrest. After resuscitation, an echocardiogram revealed severe left ventricular (LV) dysfunction with cardiac tamponade. Emergent pericardiocentesis was done and 50 mL of pericardial fluid was drained. An extra-pericardial mass compressing the left atrium was also suspected, but images were limited. Electrocardiogram showed 1 mm ST segment elevation in anterior chest leads (Figure 1). Initial labs revealed elevated troponin I (8.38 ng/mL) and creatine kinase-MB (21 ng/mL). Since this suggested possible acute myocardial infarction, she was emergently taken for cardiac catheterization, but no coronary artery disease was detected. She was hemodynamically sustained with inotropes and an intraaortic balloon pump (IABP).


Fulminant giant cell myocarditis and cardiogenic shock: an unusual presentation of malignant thymoma.

Koul D, Kanwar M, Jefic D, Kolluru A, Singh T, Dhar S, Kumar P, Cohen G - Cardiol Res Pract (2010)

Electrocardiogram showing ST segment elevation in leads I, aVL, and V2–V6.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2864446&req=5

fig1: Electrocardiogram showing ST segment elevation in leads I, aVL, and V2–V6.
Mentions: A previously healthy 55-year-old woman presented with one-week history of worsening muscle weakness, diplopia, and exertional dyspnea. Physical examination revealed a pale thin female with tachycardia (107 beats/minute), tachypnea (22 breaths/minute), hypotension (blood pressure 86/50 mmHg), jugular venous distension with rapid “×” descent, and distant heart sounds. While the patient was being evaluated in the emergency room, she suddenly had a cardiopulmonary arrest. After resuscitation, an echocardiogram revealed severe left ventricular (LV) dysfunction with cardiac tamponade. Emergent pericardiocentesis was done and 50 mL of pericardial fluid was drained. An extra-pericardial mass compressing the left atrium was also suspected, but images were limited. Electrocardiogram showed 1 mm ST segment elevation in anterior chest leads (Figure 1). Initial labs revealed elevated troponin I (8.38 ng/mL) and creatine kinase-MB (21 ng/mL). Since this suggested possible acute myocardial infarction, she was emergently taken for cardiac catheterization, but no coronary artery disease was detected. She was hemodynamically sustained with inotropes and an intraaortic balloon pump (IABP).

Bottom Line: Malignant thymoma is rarely associated with giant cell myocarditis.We present a case study that illustrates this association and cardiogenic shock with underlying tamponade.The dramatic presentation of this scenario has not been previously described.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Cardiac Cath Laboratory, St. John Hospital and Medical Center, 22101 Moross Road, 2nd Floor VEP, Detroit, MI 48236, USA.

ABSTRACT
Malignant thymoma is rarely associated with giant cell myocarditis. We present a case study that illustrates this association and cardiogenic shock with underlying tamponade. The dramatic presentation of this scenario has not been previously described.

No MeSH data available.


Related in: MedlinePlus