Han Jungwuk
Internal Medicine, Weiss Memorial Hospital, Chicago, USA.
Cureus. 2024 Dec 4;16(12):e75093. doi: 10.7759/cureus.75093. eCollection 2024 Dec.
A previously healthy, 28-year-old man presented with a two-day history of diarrhea and chest pain, suggestive of infectious myocarditis. Initial workup revealed elevated troponin-I levels and diffuse ST-segment elevations on electrocardiogram (ECG). Transthoracic echocardiography showed a reduced left ventricular ejection fraction (40-45%), posteroinferior wall akinesis, and a small pericardial effusion. Stool studies were positive for rotavirus antigen via enzyme immunoassay (EIA). Cardiac magnetic resonance imaging (MRI) and endomyocardial biopsy (EMB) were not performed due to facility limitations; however, clinical findings, troponin-I trends, and echocardiographic abnormalities supported the diagnosis of rotavirus-associated myocarditis. The patient was treated with oral rehydration, colchicine, and metoprolol, leading to symptom resolution and a decline in troponin-I levels. This case underscores the importance of considering rotavirus as a potential etiologic agent in myocarditis, even in immunocompetent adults without significant comorbidities, and highlights the need for clinicians to recognize gastrointestinal viruses as possible causes of cardiac inflammation.
一名既往健康的28岁男性，出现腹泻和胸痛两天，提示感染性心肌炎。初始检查发现肌钙蛋白I水平升高，心电图（ECG）显示广泛ST段抬高。经胸超声心动图显示左心室射血分数降低（40 - 45%），下后壁运动减弱，少量心包积液。粪便研究通过酶免疫测定（EIA）检测轮状病毒抗原呈阳性。由于设备限制，未进行心脏磁共振成像（MRI）和心内膜心肌活检（EMB）；然而，临床发现、肌钙蛋白I变化趋势和超声心动图异常支持轮状病毒相关性心肌炎的诊断。患者接受口服补液、秋水仙碱和美托洛尔治疗，症状缓解，肌钙蛋白I水平下降。该病例强调了即使在无明显合并症的免疫功能正常成年人中，也需考虑轮状病毒作为心肌炎潜在病因的重要性，并突出了临床医生认识到胃肠道病毒可能是心脏炎症病因的必要性。
