title: [Fulminant myocarditis causing severe left heart failure and massive thrombus formation following cardiac tamponade: a case report].
abstract: A woman aged middle thirties presented with common cold-like symptoms, and was hospitalized due to hypotension and tachycardia. Echocardiography revealed pericardial effusion and preserved left ventricular fractional shortening (28%). Cardiac index, pulmonary capillary wedge and right atrial pressure were 1.8 l/min/m2, 15 and 13 mmHg, respectively. After drainage of pericardial effusion, cardiac index increased to 3.4 l/min/m2. On the fifth hospital day, left ventricular dysfunction developed (fractional shortening: 16%, cardiac index: 1.5 l/min/m2, pulmonary capillary wedge pressure: 18 mmHg, right atrial pressure: 12 mmHg), so percutaneous cardiopulmonary support was introduced. However, the heart failed in asystole and the cavity was occupied by massive thrombus, probably related to heparin-induced thrombocytopenia. This case of fulminant myocarditis passed through various clinical features of heart failure. She died on the 12th hospital day.
authors.affiliation: Department of Cardiology, National Cardiovascular Center, Fujishirodai 5 7- 1, Suita, Osaka 565-8565.
authors.forename: Koji
authors.initials: K
authors.lastname: Miyamoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
authors.forename: Teruo
authors.initials: T
authors.lastname: Noguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanimoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kakuchi
authors.forename: Isao
authors.initials: I
authors.lastname: Morii
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakatani
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nonogi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Goto
authors.forename: Shunichi
authors.initials: S
authors.lastname: Miyazaki
mesh_terms: D000328:Adult; D002305:Cardiac Tamponade / Q000209:etiology*; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006331:Heart Diseases / Q000209:etiology*; D006333:Heart Failure / Q000209:etiology*; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D009205:Myocarditis / Q000150:complications*; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000150:complications; D013927:Thrombosis / Q000209:etiology*; D018487:Ventricular Dysfunction, Left / Q000209:etiology*
chemical_list: D006493:Heparin