心肌炎是一种影响心肌细胞的炎症性疾病,主要由病毒引起。它可以表现为胸痛,呼吸困难,心悸,疲劳,晕厥,呼吸急促,在严重的情况下,会发生心源性休克。它约占年轻人心脏猝死的10%,他们被描述为三十出头。由急性心肌炎引起的炎症性心肌病也可能表现为新发心力衰竭(HF)。延迟这些患者的诊断和治疗。认识到症状发作的敏感性至关重要,特别是在年轻个体中;与左心室射血分数(LVEF)受损和相关左心室扩张的严重程度不一致的轻度肌钙蛋白水平升高强烈提示炎症性心肌病而非急性心肌炎。目前心肌炎的治疗主要是支持性治疗,强调按照临床实践指南管理心力衰竭和心律失常。在这个案例报告中,我们描述了一个四十岁出头的男性,他突然出现劳力性呼吸急促和胸部不适。他的心导管检查没有显示冠状动脉疾病的证据;然而,超声心动图显示新发心力衰竭,射血分数降低,柯萨奇病毒性心肌炎的诊断是基于他的临床表现,和阳性柯萨奇病毒免疫测定。
Myocarditis is an inflammatory condition that impacts cardiac myocytes and is caused mostly by viruses. It can manifest as chest pain, dyspnea, palpitations, fatigue, syncope, shortness of breath, and in severe cases frank cardiogenic shock. It accounts for around 10 percent of all sudden cardiac deaths in young adults, who are described as being in their early thirties. Inflammatory cardiomyopathy resulting from acute myocarditis may also appear as new-onset heart failure (HF), delaying the diagnosis and treatment of these patients. It is crucial to recognize the sensitivity of symptom onset, especially in young individuals; mildly elevated troponin levels that are inconsistent with the severity of left ventricular ejection fraction (LVEF) impairment and associated left ventricular dilatation strongly suggest inflammatory cardiomyopathy rather than acute myocarditis. The current treatment for myocarditis is primarily supportive, with an emphasis on the management of heart failure and arrhythmias in accordance with clinical practice guidelines. In this case report, we describe a male in his early forties who presented with abrupt onset exertional shortness of breath and chest discomfort. His cardiac catheterization did not show evidence of coronary artery disease; however, an echocardiogram revealed new-onset heart failure with reduced ejection fraction, the diagnosis of coxsackievirus myocarditis was made based on his clinical presentation, and a positive coxsackievirus immunoassay.