Department of Cardiology, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030, USA.
Department of Internal Medicine, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030, USA.
Future Cardiol. 2022 Dec;18(12):925-929. doi: 10.2217/fca-2022-0078. Epub 2022 Nov 22.
We present a case of a 30-year-old female with no pertinent medical history who presented with 4 days of chest pressure, dyspnea and fever. She had hemodynamic compromise and had elevated cardiac and inflammatory markers consistent with cardiogenic shock. ECG demonstrated anterior ST-segment elevations with reciprocal changes. Coronary angiography revealed normal coronaries and echocardiogram showed severe biventricular dysfunction. Endomyocardial biopsy showed signs of lymphocytic myocarditis and viral testing was positive for Coxsackie A. She was initially supported with an intra-aortic balloon pump and later escalated to venoarterial extracorporeal membrane oxygenation due to electromechanical compromise. With supportive care, she was weaned off venoarterial extracorporeal membrane oxygenation and made a full myocardial recovery on follow up echocardiogram and cardiac MRI.
我们报告了一例 30 岁女性病例，该患者无相关病史，出现 4 天胸痛、呼吸困难和发热。她出现血流动力学障碍，并伴有心肌梗死和心源性休克的标志物升高。心电图显示前壁 ST 段抬高伴对应导联改变。冠状动脉造影显示正常冠状动脉，超声心动图显示严重的双心室功能障碍。心肌活检显示淋巴细胞性心肌炎的迹象，病毒检测柯萨奇 A 阳性。她最初使用主动脉内球囊泵支持，后来由于电机械功能障碍而升级为静脉动脉体外膜肺氧合。通过支持性治疗，她成功地脱离了静脉动脉体外膜肺氧合，在后续的超声心动图和心脏 MRI 检查中完全恢复了心肌功能。
