Acute right ventricular myocarditis presenting with chest pain and syncope

BMJ Case Rep. 2013 Oct 4:2013:bcr2012007173. doi: 10.1136/bcr-2012-007173.

Abstract

Myocarditis is assumed to involve both ventricles equally. Right ventricular predominant involvement is rarely described. A case of acute viral right ventricular myocarditis presenting with chest pain and syncope, grade 3 atrioventricular block, right ventricular dilatation and free wall hypokinesia is reported. Cardiac MRI showed late enhancement of the right ventricular free wall without involvement of the left ventricle. Anti-Coxsackie A9 virus neutralising IgM-type antibodies titre was elevated. This case emphasises that manifestations of myocarditis can be limited to the right ventricle and should be considered in the differential diagnosis of right ventricular enlargement.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Atrioventricular Block / diagnosis
  • Atrioventricular Block / virology
  • Biomarkers / blood
  • Chest Pain / diagnosis
  • Chest Pain / virology
  • Comorbidity
  • Diagnosis, Differential
  • Diagnostic Imaging
  • Electrocardiography
  • Enterovirus B, Human / pathogenicity
  • Enterovirus Infections / diagnosis*
  • Enterovirus Infections / therapy
  • Enterovirus Infections / virology*
  • Humans
  • Male
  • Middle Aged
  • Myocarditis / diagnosis*
  • Myocarditis / therapy
  • Myocarditis / virology*
  • Syncope / diagnosis
  • Syncope / virology
  • Ventricular Dysfunction, Right / diagnosis*
  • Ventricular Dysfunction, Right / therapy
  • Ventricular Dysfunction, Right / virology*

Substances

  • Biomarkers