Likely tuberculous myocarditis mimicking an acute coronary syndrome.
Acute systemic infections may involve the heart, mostly represented by myocarditis and pericarditis. We report the case of a likely myopericarditis in an adult, leading to the diagnosis of tuberculosis infection. The clinical presentation was an acute coronary syndrome with elevated troponin Ic. An alternative diagnosis of myopericarditis was considered. Chest X-ray depicted a miliary pattern and a CT-scan demonstrated bilateral micronodules with a "tree-in-bud" pattern associated with parenchymal consolidations in the apical segment of the left upper lobe, suggesting infectious bronchiolitis. As the direct microscopic examination of the bronchial expectoration revealed the presence of Koch's bacterium, a diagnosis of a tuberculous myocarditis was likely. The clinical, electrocardiographic and CT-scan findings are shown; cardiac effects associated with tuberculosis are discussed.
Roubille
François
F
Cardiology Department, CHU Arnaud de Villeneuve, Montpellier, France. f-roubille@chu-montpellier.fr
Gahide
Gérald
G
Granier
Mathieu
M
Cornillet
Luc
L
Vernhet-Kovacsik
Hélène
H
Moore-Morris
Tom
T
Macia
Jean-Christophe
JC
Piot
Christophe
C
D054058:Acute Coronary Syndrome / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014381:Tuberculosis, Cardiovascular / Q000175:diagnosis* / Q000000981:diagnostic imaging