JACC. Case reports最新文献_第7页

Not All That Grows Is Malignant 并非所有生长的都是恶性的：良性心包囊肿的线索。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-09-25 DOI: 10.1016/j.jaccas.2026.110278

Ellis Y. Kim MD, PhD, Mohammed Ruzieh MD, MSE

引用次数: 0

Cardiac Tamponade From Lymphocytic Constrictive Pericarditis in Primary AL Amyloidosis Without Myocardial Involvement 未累及心肌的原发性AL淀粉样变性患者淋巴细胞缩窄性心包炎引起的心包填塞。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-06 DOI: 10.1016/j.jaccas.2026.109538

Yen Hsin Leong MD, Zhenwei Teo MBBS, MMed, Edwin Chong Yu Sng MBBS, MMed, Siang Hui Lai MBBS, DMJ, Marvin Raden Torres De Guzman MD, Felix Maverick Uy MD

{"title":"Cardiac Tamponade From Lymphocytic Constrictive Pericarditis in Primary AL Amyloidosis Without Myocardial Involvement","authors":"Yen Hsin Leong MD, Zhenwei Teo MBBS, MMed, Edwin Chong Yu Sng MBBS, MMed, Siang Hui Lai MBBS, DMJ, Marvin Raden Torres De Guzman MD, Felix Maverick Uy MD","doi":"10.1016/j.jaccas.2026.109538","DOIUrl":"10.1016/j.jaccas.2026.109538","url":null,"abstract":"<div><h3>Background</h3><div>Isolated pericardial involvement in systemic light chain (AL) amyloidosis without myocardial infiltration is extraordinarily rare. Constrictive pericarditis with cardiac tamponade as the sole cardiac manifestation has not been previously reported.</div></div><div><h3>Case Summary</h3><div>A 69-year-old man presented with exertional dyspnea and was diagnosed with a large pericardial effusion with features of constrictive pericarditis. Pericardiocentesis and pericardial biopsy showed lymphocytic effusion without cardiac amyloid involvement. Biopsy of a prevertebral mass later revealed amyloid deposition, confirming systemic AL amyloidosis. He was treated with immunochemotherapy but was unfit for autologous stem cell transplant.</div></div><div><h3>Discussion</h3><div>This case highlights the diagnostic challenges of AL amyloidosis, especially with concomitant pericardial disease without myocardial involvement. Pericardial disease may reflect an inflammatory process rather than direct amyloid infiltration. Diagnosis is challenging given atypical presentations and limited sensitivities of initial monoclonal protein testing.</div></div><div><h3>Take-Home Messages</h3><div>Consider AL amyloidosis in unexplained pericardial disease. Negative monoclonal studies do not exclude systemic amyloidosis. Pursue myocardial biopsy if suspicion persists.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109538"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unmasking Latent Left Ventricular Outflow Tract Obstruction in Hypertrophic Cardiomyopathy 肥厚性心肌病潜在左心室流出道梗阻的揭露：有创和无创评估。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-22 DOI: 10.1016/j.jaccas.2026.109898

Hyunseok Cho MD, Jihoon Kim MD, PhD, Sang-Chol Lee MD, PhD, Ki Hong Choi MD, PhD, Jeong Hoon Yang MD, PhD

{"title":"Unmasking Latent Left Ventricular Outflow Tract Obstruction in Hypertrophic Cardiomyopathy","authors":"Hyunseok Cho MD, Jihoon Kim MD, PhD, Sang-Chol Lee MD, PhD, Ki Hong Choi MD, PhD, Jeong Hoon Yang MD, PhD","doi":"10.1016/j.jaccas.2026.109898","DOIUrl":"10.1016/j.jaccas.2026.109898","url":null,"abstract":"<div><h3>Background</h3><div>Dynamic left ventricular outflow tract (LVOT) obstruction in hypertrophic cardiomyopathy may be missed on resting echocardiography, and it requires provocation for detection.</div></div><div><h3>Case Summary</h3><div>A 41-year-old man with previously classified nonobstructive hypertrophic cardiomyopathy presented with recurrent syncope. Serial echocardiography had demonstrated no significant dynamic LVOT obstruction. During reassessment, repeated Doppler interrogation with Valsalva maneuver revealed variable pressure gradients ranging from 25 to 46 mm Hg. Exercise stress echocardiography further unmasked severe LVOT obstruction, with a peak gradient of 108 mm Hg and worsening mitral regurgitation. Multimodality assessment, including postextrasystolic provocation and invasive hemodynamics, demonstrated comparable augmentation of LVOT gradients. Mavacamten therapy eliminated LVOT obstruction, with no recurrence of syncope.</div></div><div><h3>Discussion</h3><div>Exercise-induced gradients paralleled those obtained with mechanistic provocation, indicating that physiologic stress can reliably reflect the magnitude of latent obstruction.</div></div><div><h3>Take-Home Message</h3><div>Exercise stress echocardiography, supported by complementary provocation, may provide a practical approach to identify clinically significant latent LVOT obstruction.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109898"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

AL Cardiac Amyloidosis Mimicking Dilated Cardiomyopathy With Reduced Ejection Fraction and Absent Apical Sparing AL心脏淀粉样变性模拟扩张型心肌病伴射血分数降低和无根尖保留。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-26 DOI: 10.1016/j.jaccas.2026.109997

George G. Kidess MD, Maria Kaufman MD, Nitasha Sarswat MD, Syeda Ayesha Hasan MD, Christina LaFaire MD, Jeremy Slivnick MD

{"title":"AL Cardiac Amyloidosis Mimicking Dilated Cardiomyopathy With Reduced Ejection Fraction and Absent Apical Sparing","authors":"George G. Kidess MD, Maria Kaufman MD, Nitasha Sarswat MD, Syeda Ayesha Hasan MD, Christina LaFaire MD, Jeremy Slivnick MD","doi":"10.1016/j.jaccas.2026.109997","DOIUrl":"10.1016/j.jaccas.2026.109997","url":null,"abstract":"<div><h3>Background</h3><div>Amyloid light chain (AL) amyloidosis is a rapidly progressive disease with significant untreated mortality especially when diagnosis is delayed, making early detection of disease crucial. Various cardiac imaging modalities are emerging as alternatives to echocardiography for the early detection of this disease.</div></div><div><h3>Case Summary</h3><div>A patient presented with progressive heart failure symptoms and was evaluated with an echocardiogram showing a mildly dilated left ventricle, moderate systolic dysfunction, only mildly increased left ventricular wall thickness, and reduced global longitudinal strain without apical sparing. Cardiac magnetic resonance (CMR) showed diffuse, patchy late gadolinium enhancement. Endomyocardial biopsy confirmed AL cardiac amyloidosis (CA). The patient was treated with guideline-directed medical therapy and chemotherapy agents.</div></div><div><h3>Discussion</h3><div>Although echocardiography has great utility as a screening tool for cardiac amyloidosis given its widespread availability, this case highlights its potential limitations and emphasizes the importance of CMR for evaluation of dilated cardiomyopathies and CA detection.</div></div><div><h3>Take-Home Messages</h3><div>CA may present with dilated cardiomyopathy and lack classic echocardiographic features. Early CMR may facilitate timely diagnosis of CA.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109997"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incidental Atrial Amyloid on Surgical Pathology Revealing Transthyretin Cardiac Amyloidosis 外科病理显示经甲状腺素型心脏淀粉样变性的偶发性心房淀粉样蛋白。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-25 DOI: 10.1016/j.jaccas.2026.109925

Jonathan Wright MD, Fadi Haroun MD, Adam Potter MD, PhD, Ajay Vallakati MBBS, Bryan Whitson MD, PhD, Rami Kahwash MD

{"title":"Incidental Atrial Amyloid on Surgical Pathology Revealing Transthyretin Cardiac Amyloidosis","authors":"Jonathan Wright MD, Fadi Haroun MD, Adam Potter MD, PhD, Ajay Vallakati MBBS, Bryan Whitson MD, PhD, Rami Kahwash MD","doi":"10.1016/j.jaccas.2026.109925","DOIUrl":"10.1016/j.jaccas.2026.109925","url":null,"abstract":"<div><h3>Background</h3><div>Atrial amyloid is frequently encountered incidentally on surgical specimens and often attributed to isolated atrial amyloidosis. However, atrial amyloid may also represent early transthyretin amyloid (ATTR) cardiac amyloidosis (CA), a treatable condition.</div></div><div><h3>Case Summary</h3><div>A 70-year-old man presented with worsening dyspnea, lower-extremity edema, and atrial fibrillation. He underwent coronary artery bypass grafting with MAZE procedure and left atrial appendage ligation. Pathology of the atrial appendage revealed Congo red-positive amyloid deposits. Mass spectrometry confirmed transthyretin-type amyloid. Transthyretin gene sequencing was negative, and technetium-99m pyrophosphate scintigraphy demonstrated significant cardiac uptake, confirming wild-type ATTR CA. He was treated with tafamidis and spironolactone, maintained sinus rhythm after cardioversion, and remained clinically stable at 1-year follow-up.</div></div><div><h3>Discussion</h3><div>This case highlights the diagnostic value of atrial tissue histopathology in detecting occult ATTR amyloidosis. Further, it emphasizes the importance of comprehensive evaluation and early initiation of disease-modifying therapy. Proper evaluation of atrial amyloid can alter management and improve patient outcomes.</div></div><div><h3>Take-Home Messages</h3><div>Atrial amyloid identified on surgical pathology should prompt comprehensive evaluation for CA. Atrial amyloid should not be assumed to represent isolated atrial amyloidosis, as it may provide an opportunity for early diagnosis and initiation of disease-modifying therapy.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109925"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of Acute Coronary Syndrome in Severe Diffuse Coronary Artery Ectasia 严重弥漫性冠状动脉扩张急性冠脉综合征的治疗：一个治疗挑战。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-09-11 DOI: 10.1016/j.jaccas.2026.110203

Ahmed Reda Gonnah MD, Fahdem Iamrl MD, Douglas Jacoby MD, Allison L. Tsao MD, Mahesh K. Vidula MD, Daniel E. Soffer MD, Monika Sanghavi MD

{"title":"Management of Acute Coronary Syndrome in Severe Diffuse Coronary Artery Ectasia","authors":"Ahmed Reda Gonnah MD, Fahdem Iamrl MD, Douglas Jacoby MD, Allison L. Tsao MD, Mahesh K. Vidula MD, Daniel E. Soffer MD, Monika Sanghavi MD","doi":"10.1016/j.jaccas.2026.110203","DOIUrl":"10.1016/j.jaccas.2026.110203","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery ectasia (CAE) predisposes to abnormal flow, thrombosis, and adverse cardiovascular outcomes.</div></div><div><h3>Case Summary</h3><div>A 72-year-old woman with diffuse multivessel CAE, systemic arterial ectasia, and psoriasis presented with inferior ST-segment elevation myocardial infarction in the setting of left bundle branch block. Angiography demonstrated an approximately 8-mm ectatic right coronary artery with complete thrombotic occlusion. Aspiration thrombectomy restored partial flow, but stenting was deferred because of diffuse ectasia, persistent thrombus, and malapposition risk. She was discharged on a direct oral anticoagulant plus single antiplatelet therapy.</div></div><div><h3>Discussion</h3><div>Diffuse CAE is a high-risk thrombotic substrate, and ST-segment elevation myocardial infarction management is challenging because of altered flow, large thrombus burden, and percutaneous coronary intervention limitations.</div></div><div><h3>Take-Home Message</h3><div>Diffuse systemic ectasia warrants individualized antithrombotic therapy and longitudinal imaging surveillance.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110203"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hydroxychloroquine Cardiotoxicity Mimicking Transthyretin Cardiac Amyloidosis in a Patient With HFpEF 羟基氯喹心脏毒性模拟HFpEF患者转甲状腺素型心脏淀粉样变性

JACC. Case reports Pub Date : 2026-10-21 DOI: 10.1016/j.jaccas.2026.110638

Moses Asempah MD, Elie Kozaily MD, Izabela Abissi DO, Clarence Silvis DO, Corynne Caballero MD, Deven Champaneri MD, Sheldon E. Litwin MD, Matthew J. Belanger MD

{"title":"Hydroxychloroquine Cardiotoxicity Mimicking Transthyretin Cardiac Amyloidosis in a Patient With HFpEF","authors":"Moses Asempah MD, Elie Kozaily MD, Izabela Abissi DO, Clarence Silvis DO, Corynne Caballero MD, Deven Champaneri MD, Sheldon E. Litwin MD, Matthew J. Belanger MD","doi":"10.1016/j.jaccas.2026.110638","DOIUrl":"10.1016/j.jaccas.2026.110638","url":null,"abstract":"<div><h3>Background</h3><div>Hydroxychloroquine (HCQ) is an immunomodulatory drug used in systemic lupus erythematosus and other rheumatologic disorders, with rare but potentially severe cardiotoxic effects.</div></div><div><h3>Case Summary</h3><div>A 77-year-old woman with a history of systemic lupus erythematosus and heart failure with preserved ejection fraction presented with subacute worsening chest pain, dyspnea, palpitations, and neuropathy. Electrocardiogram showed low voltage; echocardiogram revealed moderate concentric left ventricular hypertrophy with reduced global longitudinal strain without apical sparing. Coronary angiography was normal. Technetium-99m pyrophosphate scintigraphy showed focal grade 2 uptake. Endomyocardial biopsy revealed widespread myocyte hypertrophy and lysosomal curvilinear bodies consistent with HCQ cardiotoxicity.</div></div><div><h3>Discussion</h3><div>HCQ is a long-term medication used in connective tissue diseases. Patients with rheumatologic conditions are at increased risk for heart failure with preserved ejection fraction independent of HCQ use. Recognition of insidious organ toxicity can be challenging. HCQ toxicity can cause infiltrative pathology and mimic transthyretin cardiac amyloidosis. Endomyocardial biopsy is key for definitive diagnosis.</div></div><div><h3>Take-Home Message</h3><div>In patients with an equivocally positive technetium-99m pyrophosphate scan and chronic HCQ use, endomyocardial biopsy should be considered to differentiate drug toxicity from transthyretin cardiac amyloidosis.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110638"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149233789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Angiomatoid Fibrous Histiocytoma 血管瘤样纤维组织细胞瘤：一种异常罕见的肺动脉肿瘤，表现为无症状的心脏杂音。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-09-03 DOI: 10.1016/j.jaccas.2026.110028

Zulkifl Jafary MD, Saim Rana MD, Megan Vaughan MD, Iraj Hasan MD, Thomas Ogershok MD, Erick Trent MD, Hangyu Watson MD, Prashanti Atluri MD, Harshith Thyagaturu MD

{"title":"Angiomatoid Fibrous Histiocytoma","authors":"Zulkifl Jafary MD, Saim Rana MD, Megan Vaughan MD, Iraj Hasan MD, Thomas Ogershok MD, Erick Trent MD, Hangyu Watson MD, Prashanti Atluri MD, Harshith Thyagaturu MD","doi":"10.1016/j.jaccas.2026.110028","DOIUrl":"10.1016/j.jaccas.2026.110028","url":null,"abstract":"<div><h3>Background</h3><div>Angiomatoid fibrous histiocytoma (AFH), a type of primary pulmonary artery tumor, is a rare pathology without well-established risk factors, making it a challenging diagnosis.</div></div><div><h3>Case Summary</h3><div>A 28-year-old man with a history of stage 3 Burkitt lymphoma in remission presented with a new systolic heart murmur. Transthoracic echocardiography noted an indeterminate structure in the main pulmonary artery. Cardiac magnetic resonance imaging and positron emission tomography-computed tomography revealed a 1.9 cm hyperintense mass attached to the pulmonic valve and main pulmonary artery wall. The patient underwent resection of the main pulmonary artery and pulmonic valve with pulmonary artery homograft implantation. Surgical pathology revealed angiomatoid fibrous histiocytoma.</div></div><div><h3>Discussion</h3><div>AFH is a rare condition with poor outcomes that is often mistaken for pulmonary embolism. Prompt diagnosis and intervention are crucial to improve prognosis.</div></div><div><h3>Take-Home Message</h3><div>AFH is a rare pathology with poor prognosis that should be considered in all patients with prior oncologic history presenting with a cardiac murmur.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110028"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Catheter-Based Ventricular Assist Device–Induced Severe Hyperthermia 基于导管的心室辅助装置诱导的严重热疗。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-09-02 DOI: 10.1016/j.jaccas.2026.110201

Sarah Noorani MD, Tyson Burnham MD, Eric Zuniga MD, MBA, Antonio H. Frangieh MD, MPH, Andy Y. Lee MD

{"title":"Catheter-Based Ventricular Assist Device–Induced Severe Hyperthermia","authors":"Sarah Noorani MD, Tyson Burnham MD, Eric Zuniga MD, MBA, Antonio H. Frangieh MD, MPH, Andy Y. Lee MD","doi":"10.1016/j.jaccas.2026.110201","DOIUrl":"10.1016/j.jaccas.2026.110201","url":null,"abstract":"<div><h3>Background</h3><div>Hemolysis is a potential complication of catheter-based ventricular assist devices (CVADs), but severe hyperthermia is a rare occurrence that significantly affects further management and outcomes.</div></div><div><h3>Case Summary</h3><div>A young man with toxic methamphetamine-associated cardiomyopathy presented with cardiogenic shock, prompting placement of a CVAD. He soon developed severe hyperthermia unresponsive to cooling measures. The hyperthermia ultimately subsided with removal of the device.</div></div><div><h3>Discussion</h3><div>Hemolysis and renal failure are known complications of CVAD placement. The hyperthermia in this patient was likely related to erythrocytosis, highly viscous blood, and resulting hemolysis. The patient returned to normothermia only after removal of the device, supporting the idea that the CVAD was a cause of hyperthermic episode.</div></div><div><h3>Take-Home Messages</h3><div>The use of CVADs in cardiogenic shock offers favorable outcomes but has potential complications. This unique case of severe hyperthermia resulting from massive hemolysis that required prompt removal of the device supports a rare, high-morbidity potential complication.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110201"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute Myocarditis Presenting as Neck Pain With Severe Systemic Inflammation 急性心肌炎表现为颈部疼痛并伴有严重的全身炎症。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-18 DOI: 10.1016/j.jaccas.2026.109796

Ayesha Fayyaz MBBS, Sher Wali Khan MBBS, EECC, Mariam Azam MD, Madiha Rabbani MD, Valaine Hewitt MD

{"title":"Acute Myocarditis Presenting as Neck Pain With Severe Systemic Inflammation","authors":"Ayesha Fayyaz MBBS, Sher Wali Khan MBBS, EECC, Mariam Azam MD, Madiha Rabbani MD, Valaine Hewitt MD","doi":"10.1016/j.jaccas.2026.109796","DOIUrl":"10.1016/j.jaccas.2026.109796","url":null,"abstract":"<div><h3>Background</h3><div>Acute myocarditis classically presents with chest pain, dyspnea, and arrhythmias; however, atypical and extracardiac presentations may delay recognition. We describe an unusual presentation characterized by unilateral neck pain, dysphagia, profound systemic inflammation, and reversible cardiogenic shock.</div></div><div><h3>Case Summary</h3><div>A 35-year-old previously healthy woman initially presented with unilateral neck pain, dysphagia, and constitutional symptoms without chest pain or dyspnea. She developed hypotension requiring vasopressors, marked leukocytosis, thrombocytopenia, transaminitis, elevated cardiac biomarkers, and severe left ventricular dysfunction (ejection fraction 30%). Cardiac magnetic resonance showed elevated native T1 values and extracellular volume suggestive of diffuse myocardial injury. After infectious causes were excluded, corticosteroid therapy resulted in complete recovery within 1 week.</div></div><div><h3>Discussion</h3><div>Extracardiac symptoms initially obscured the diagnosis; parametric cardiac magnetic resonance mapping proved diagnostically valuable.</div></div><div><h3>Take-Home Messages</h3><div>Myocarditis may present with atypical extracardiac inflammatory symptoms. Parametric cardiac magnetic resonance mapping can support diagnosis when conventional imaging findings are limited or absent.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109796"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0