Document Detail

Acute myocarditis in fulminant systemic sclerosis.
MedLine Citation:
PMID:  1541169     Owner:  NLM     Status:  MEDLINE    
Myositis and myocarditis have been reported in progressive systemic sclerosis, and these patients have had favorable therapeutic responses to intravenous pulse methylprednisolone. Thus far, premortem biopsy documentation of myocarditis and myocardial fibrosis has not been reported in such patients. We report the case of a patient with subacute congestive heart failure six months after she developed Raynaud's phenomenon. Clinical examination was typical of scleroderma but there was no proximal muscle weakness. She had elevated creatine kinase and MB-creatine kinase and laboratory evidence of hypothyroidism. Echocardiogram demonstrated four-chamber dilatation and severe left ventricular dysfunction. Cardiac catheterization revealed normal epicardial coronary arteries and severely decreased cardiac index. A skin biopsy specimen of the forearm was consistent with diffuse systemic sclerosis, and an endomyocardial biopsy specimen demonstrated mild fibrosis and lymphocytic infiltrate. Her heart failure initially improved with digoxin, furosemide, and enalapril. She also received L-thyroxine and intravenous methylprednisolone. The heart failure progressed over the next six weeks and she died. Patients with scleroderma and new-onset heart failure may have acute myocarditis.
B S Clemson; W R Miller; J C Luck; J A Feriss
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Chest     Volume:  101     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-04-08     Completed Date:  1992-04-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  872-4     Citation Subset:  AIM; IM    
Department of Medicine, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
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MeSH Terms
Acute Disease
Heart Failure / etiology
Myocarditis / diagnosis,  etiology*
Scleroderma, Systemic / complications*,  pathology

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