Iatrogenic Complications During the Diagnostic Work-Up of an Inflammatory Cardiomyopathy
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , |
Tipo de documento: | Relatório |
Idioma: | eng |
Título da fonte: | International Journal of Cardiovascular Sciences (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472020000600729 |
Resumo: | Abstract A 72-year-old woman was admitted for acute heart failure. The echocardiography revealed moderate depression of the left ventricular ejection fraction. Coronary disease was excluded by coronarography. Cardiac magnetic resonance showed predominantly left ventricular septal hypertrophy and severe depression of the left ventricular systolic function. There was also a bright, multifocal and patchy late gadolinium enhancement with subendocardial, mesocardial and subepicardial involvement, suggestive of sarcoidosis. Biochemical study, thoracic computed tomography and positron emission tomography were inconclusive for extra-cardiac sarcoidosis. Therefore, an endomyocardial biopsy was performed. The procedure was complicated by the development of complete atrioventricular block, requiring implantation of a cardiac resynchronization pacing device. A few days after device implantation, the patient developed fever. The echocardiography revealed extensive vegetations, and thus the diagnosis of a device-associated infective endocarditis was made. Even though antibiotic therapy was promptly started, the patient ended up dying. Biopsy results revealed lymphocytic myocarditis. This case is paradigmatic because it shows how the etiologic diagnosis of dilated cardiomyopathy can be challenging. Non-invasive diagnostic exams may not provide a definite diagnosis, requiring an endomyocardial biopsy. However, the benefits versus risks of such procedure must always be carefully weighted. |
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Iatrogenic Complications During the Diagnostic Work-Up of an Inflammatory CardiomyopathyIatrogenic Disease/complicationsCardiomyopathiesDiabetes MellitusHypertensionEndocarditesCardiomyopathy, DilatedSpectroscopy, Magnetic Resonance/methodsAbstract A 72-year-old woman was admitted for acute heart failure. The echocardiography revealed moderate depression of the left ventricular ejection fraction. Coronary disease was excluded by coronarography. Cardiac magnetic resonance showed predominantly left ventricular septal hypertrophy and severe depression of the left ventricular systolic function. There was also a bright, multifocal and patchy late gadolinium enhancement with subendocardial, mesocardial and subepicardial involvement, suggestive of sarcoidosis. Biochemical study, thoracic computed tomography and positron emission tomography were inconclusive for extra-cardiac sarcoidosis. Therefore, an endomyocardial biopsy was performed. The procedure was complicated by the development of complete atrioventricular block, requiring implantation of a cardiac resynchronization pacing device. A few days after device implantation, the patient developed fever. The echocardiography revealed extensive vegetations, and thus the diagnosis of a device-associated infective endocarditis was made. Even though antibiotic therapy was promptly started, the patient ended up dying. Biopsy results revealed lymphocytic myocarditis. This case is paradigmatic because it shows how the etiologic diagnosis of dilated cardiomyopathy can be challenging. Non-invasive diagnostic exams may not provide a definite diagnosis, requiring an endomyocardial biopsy. However, the benefits versus risks of such procedure must always be carefully weighted.Sociedade Brasileira de Cardiologia2020-12-01info:eu-repo/semantics/reportinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472020000600729International Journal of Cardiovascular Sciences v.33 n.6 2020reponame:International Journal of Cardiovascular Sciences (Online)instname:Sociedade Brasileira de Cardiologia (SBC)instacron:SBC10.36660/ijcs.20190153info:eu-repo/semantics/openAccessAntunes,HugoGil,JúlioMarmelo,BrunoGonçalves,Maria LuísaPires,Maria InêsSantos,João MiguelCorreia,MiguelCabral,José Costaeng2020-11-23T00:00:00Zoai:scielo:S2359-56472020000600729Revistahttp://publicacoes.cardiol.br/portal/ijcshttps://old.scielo.br/oai/scielo-oai.phptailanerodrigues@cardiol.br||revistaijcs@cardiol.br2359-56472359-4802opendoar:2020-11-23T00:00International Journal of Cardiovascular Sciences (Online) - Sociedade Brasileira de Cardiologia (SBC)false |
dc.title.none.fl_str_mv |
Iatrogenic Complications During the Diagnostic Work-Up of an Inflammatory Cardiomyopathy |
title |
Iatrogenic Complications During the Diagnostic Work-Up of an Inflammatory Cardiomyopathy |
spellingShingle |
Iatrogenic Complications During the Diagnostic Work-Up of an Inflammatory Cardiomyopathy Antunes,Hugo Iatrogenic Disease/complications Cardiomyopathies Diabetes Mellitus Hypertension Endocardites Cardiomyopathy, Dilated Spectroscopy, Magnetic Resonance/methods |
title_short |
Iatrogenic Complications During the Diagnostic Work-Up of an Inflammatory Cardiomyopathy |
title_full |
Iatrogenic Complications During the Diagnostic Work-Up of an Inflammatory Cardiomyopathy |
title_fullStr |
Iatrogenic Complications During the Diagnostic Work-Up of an Inflammatory Cardiomyopathy |
title_full_unstemmed |
Iatrogenic Complications During the Diagnostic Work-Up of an Inflammatory Cardiomyopathy |
title_sort |
Iatrogenic Complications During the Diagnostic Work-Up of an Inflammatory Cardiomyopathy |
author |
Antunes,Hugo |
author_facet |
Antunes,Hugo Gil,Júlio Marmelo,Bruno Gonçalves,Maria Luísa Pires,Maria Inês Santos,João Miguel Correia,Miguel Cabral,José Costa |
author_role |
author |
author2 |
Gil,Júlio Marmelo,Bruno Gonçalves,Maria Luísa Pires,Maria Inês Santos,João Miguel Correia,Miguel Cabral,José Costa |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Antunes,Hugo Gil,Júlio Marmelo,Bruno Gonçalves,Maria Luísa Pires,Maria Inês Santos,João Miguel Correia,Miguel Cabral,José Costa |
dc.subject.por.fl_str_mv |
Iatrogenic Disease/complications Cardiomyopathies Diabetes Mellitus Hypertension Endocardites Cardiomyopathy, Dilated Spectroscopy, Magnetic Resonance/methods |
topic |
Iatrogenic Disease/complications Cardiomyopathies Diabetes Mellitus Hypertension Endocardites Cardiomyopathy, Dilated Spectroscopy, Magnetic Resonance/methods |
description |
Abstract A 72-year-old woman was admitted for acute heart failure. The echocardiography revealed moderate depression of the left ventricular ejection fraction. Coronary disease was excluded by coronarography. Cardiac magnetic resonance showed predominantly left ventricular septal hypertrophy and severe depression of the left ventricular systolic function. There was also a bright, multifocal and patchy late gadolinium enhancement with subendocardial, mesocardial and subepicardial involvement, suggestive of sarcoidosis. Biochemical study, thoracic computed tomography and positron emission tomography were inconclusive for extra-cardiac sarcoidosis. Therefore, an endomyocardial biopsy was performed. The procedure was complicated by the development of complete atrioventricular block, requiring implantation of a cardiac resynchronization pacing device. A few days after device implantation, the patient developed fever. The echocardiography revealed extensive vegetations, and thus the diagnosis of a device-associated infective endocarditis was made. Even though antibiotic therapy was promptly started, the patient ended up dying. Biopsy results revealed lymphocytic myocarditis. This case is paradigmatic because it shows how the etiologic diagnosis of dilated cardiomyopathy can be challenging. Non-invasive diagnostic exams may not provide a definite diagnosis, requiring an endomyocardial biopsy. However, the benefits versus risks of such procedure must always be carefully weighted. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/report |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
report |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472020000600729 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472020000600729 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.36660/ijcs.20190153 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia |
dc.source.none.fl_str_mv |
International Journal of Cardiovascular Sciences v.33 n.6 2020 reponame:International Journal of Cardiovascular Sciences (Online) instname:Sociedade Brasileira de Cardiologia (SBC) instacron:SBC |
instname_str |
Sociedade Brasileira de Cardiologia (SBC) |
instacron_str |
SBC |
institution |
SBC |
reponame_str |
International Journal of Cardiovascular Sciences (Online) |
collection |
International Journal of Cardiovascular Sciences (Online) |
repository.name.fl_str_mv |
International Journal of Cardiovascular Sciences (Online) - Sociedade Brasileira de Cardiologia (SBC) |
repository.mail.fl_str_mv |
tailanerodrigues@cardiol.br||revistaijcs@cardiol.br |
_version_ |
1754732626545999872 |