title: Likely tuberculous myocarditis mimicking an acute coronary syndrome.
abstract: 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.
authors.affiliation: Cardiology Department, CHU Arnaud de Villeneuve, Montpellier, France. f-roubille@chu-montpellier.fr
authors.forename: François
authors.initials: F
authors.lastname: Roubille
authors.forename: Gérald
authors.initials: G
authors.lastname: Gahide
authors.forename: Mathieu
authors.initials: M
authors.lastname: Granier
authors.forename: Luc
authors.initials: L
authors.lastname: Cornillet
authors.forename: Hélène
authors.initials: H
authors.lastname: Vernhet-Kovacsik
authors.forename: Tom
authors.initials: T
authors.lastname: Moore-Morris
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Macia
authors.forename: Christophe
authors.initials: C
authors.lastname: Piot
mesh_terms: 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