title: Myopericarditis as a complication of nonspecific colitis.
abstract: METHODS
  Male, 31 FINAL DIAGNOSIS: Myopericarditis Symptoms: Abdominal pain • diarrhea
  
  
  METHODS
  - Clinical Procedure: - Specialty: Cardiology.
  
  
  OBJECTIVE
  Unusual setting of medical care.
  
  
  BACKGROUND
  Myopericarditis is a condition involving inflammation of the pericardium and myocardium. It has been reported in conjunction with inflammatory bowel disease as well as infectious colitis caused by a cardiotropic organism. The etiology of myopericarditis includes a long list of infectious causes (especially viral), toxic causes, autoimmune disorders, and vasculitides.
  
  
  METHODS
  A 31-year-old previously healthy Hispanic man complained of sudden onset of watery, non-bloody diarrhea associated with mucus and crampy abdominal pain. ECG showed ST-segment elevation in the infero-lateral leads, with elevated troponin I level. Urgent cardiac catheterization revealed normal coronary arteries and the patient was diagnosed with myopericarditis. The echocardiogram results were within normal limits, with 65% ejection fraction and no evidence of wall motion abnormalities. Colonoscopy showed macroscopically congested mucosa in the descending colon, sigmoid colon, and rectum, with scattered petechiae indicative of nonspecific colitis. Microscopic examination of obtained biopsies revealed evidence of acute mucosal inflammation without ulceration, granulomas or ischemia. The patient was started on Naproxen 250 mg twice daily and chest pain started to improve gradually. The patient was discharged on Naproxen and was followed up in clinic 2 weeks after discharge, where he was found to be completely asymptomatic, with troponin level <0.015 ng/ml.
  
  
  CONCLUSIONS
  Myopericarditis is a challenging diagnosis that has been reported in association with colitis, either as an extraintestinal manifestation of IBD or due to infectious colitis with a cardiotropic organism.
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A.
authors.forename: Haider
authors.initials: H
authors.lastname: Alkhateeb
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A.
authors.forename: Sarmad
authors.initials: S
authors.lastname: Said
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A.
authors.forename: Chad J
authors.initials: CJ
authors.lastname: Cooper
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A.
authors.forename: Sherif
authors.initials: S
authors.lastname: Elhanafi
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Teleb
authors.affiliation: Jinnah Hospital, Karachi, Pakistan.
authors.forename: Fatima
authors.initials: F
authors.lastname: Saifuddin
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A. ; Division of Cardiovascular Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Mukherjee
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A. ; Division of Cardiovascular Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A.
authors.forename: Aamer
authors.initials: A
authors.lastname: Abbas
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A.
authors.forename: Harry E
authors.initials: HE
authors.lastname: Davis
keywords: Chest Pain; Colitis; Myopericarditis; Pericarditis