{"title":"Acute hepatitis E presenting with fulminant myocarditis and cardiogenic shock: A case report from Nepal.","authors":"Ajay Bhatta, Astha Wagle, Birendra Bhandari, Sarita Kunwar, Sudip Lamsal","doi":"10.1177/00494755261499050","DOIUrl":null,"url":null,"abstract":"<p><p>Hepatitis E virus infection is endemic in Nepal and commonly presents as an acute self-limiting hepatitis. Cardiac involvement is extremely rare and may be life-threatening. We report a case of a young female who presented with fever, jaundice, progressive dyspnea and hypotension. Laboratory assessment confirmed acute hepatitis E infection. Chest radiography revealed cardiomegaly with bilateral pulmonary infiltrates. Transthoracic echocardiography demonstrated left ventricular dysfunction. Other infectious causes of myocarditis were excluded. The patient improved with inotropic support, heart failure treatment and other supportive management, with complete clinical recovery on follow-up. This case highlights the importance of early cardiac evaluation in patients with acute hepatitis E with features of heart failure.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"494755261499050"},"PeriodicalIF":0.6000,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tropical Doctor","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00494755261499050","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Hepatitis E virus infection is endemic in Nepal and commonly presents as an acute self-limiting hepatitis. Cardiac involvement is extremely rare and may be life-threatening. We report a case of a young female who presented with fever, jaundice, progressive dyspnea and hypotension. Laboratory assessment confirmed acute hepatitis E infection. Chest radiography revealed cardiomegaly with bilateral pulmonary infiltrates. Transthoracic echocardiography demonstrated left ventricular dysfunction. Other infectious causes of myocarditis were excluded. The patient improved with inotropic support, heart failure treatment and other supportive management, with complete clinical recovery on follow-up. This case highlights the importance of early cardiac evaluation in patients with acute hepatitis E with features of heart failure.
期刊介绍：
The only journal written by and for health workers in low and middle-income countries, Tropical Doctor provides medical expertise and practical advice on how to apply current medical knowledge to the special circumstances of LMIC countries. This journal provides an ideal forum for sharing experiences and establishing best practice, aiding communication between medical professionals in different environments.
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