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Right Coronary Artery Arteritis Presenting as Fulminant Myocarditis Successfully Treated with ECMO: A Case Study

Tomasz Urbanowicz, Jerzy Nożyński, Stefan Grajek, Marek Jemielity

Med Sci Tech 2016; 57:38-41

DOI: 10.12659/MST.896049


BACKGROUND: Fulminant myocarditis is a life-threatening condition requiring both vasopressor and mechanical support. Patients with acute myocarditis clinically mimic those suffering from acute coronary syndrome with the exemption of the normal appearance of coronary arteries.
CASE REPORT: We present the case of a 36-year-old man admitted to our Cardiology Clinic due to severe heart failure symptoms. Acute myocarditis was proven by endomyocardial biopsy (EMB). Due to electrocardiographic changes compounded with Troponin-I serum elevation and echocardiographic images, cine angiography was performed. Diffuse right coronary arteritis was diagnosed. Due to hemodynamic instability, intraaortic contrapulsation followed by extracorporeal membrane-oxygenation (ECMO) was applied. On the 12th day of hospitalization, signs of coronary arteritis resolution and myocarditis were noted on repeated cine angiography and endomyocardial biopsy, respectively.
CONCLUSIONS: The presented case shows the possibility of coronary artery arteritis resolution while the patient is supported by circulatory mechanical support due to cardiogenic shock in fulminant myocarditis.

Keywords: acute coronary syndrome, Arteritis, Extracorporeal Circulation, myocarditis, Shock, Cardiogenic

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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