Clinical course of myocarditis through the acute, fulminant and fatal chronic stages: an autopsy case.
Most patients with acute myocarditis manifest particular clinical signs and symptoms, including marked cardiac failure and/or a high degree of atrioventricular block on admission. However, a 78-year-old man did not have symptoms and was hospitalized as a result of abnormalities observed on an incidentally obtained electrocardiogram (ECG). Several days later, he developed cardiogenic shock and fulminant myocarditis, which required percutaneous cardiopulmonary support; however, the cardiac failure persisted and he died approximately 4 months later. The ECG showed findings similar to those of acute inferior myocardial infarction, and on left ventriculography, diffuse hypokinesis was observed most prominently in the inferoposterior wall. During autopsy, interstitial fibrosis was marked in the inferoposterior wall, with small, round, cell infiltration prominent at the same site. Clustering of these cells is a characteristic feature of chronic myocarditis.
Hiramitsu
Shinya
S
Division of Cardiology, Department of Internal Medicine, Fujita Health University School of Medicine, Toyoake, Japan. hirazy@fujita-hu.ac.jp
Morimoto
Shin-ichiro
S
Kato
Shigeru
S
Uemura
Akihisa
A
Ohtsuki
Masatsugu
M
Kato
Yasuchika
Y
Miyagishima
Kenji
K
Mori
Nami
N
Yoda
Ryuji
R
Mori
Kazumasa
K
Kimura
Hisashi
H
Yamamoto
Naoki
N
Hishida
Hitoshi
H
D000368:Aged; D001344:Autopsy; D002908:Chronic Disease; D018450:Disease Progression; D004562:Electrocardiography; D017809:Fatal Outcome; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology / Q000473:pathology; D009205:Myocarditis / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D012770:Shock, Cardiogenic / Q000209:etiology; D018487:Ventricular Dysfunction, Left / Q000473:pathology