Clinically suspected acute myopericarditis with cardiac tamponade associated with peripheral blood eosinophilia presenting in early pregnancy: a case report

Journal of Medical Case Reports

Hideyuki Takaoka²  Eiji Takai²  Naoki Murai²  Toru Tagashira²  Mayumi Shigeru²  Takashi Kida¹  Yu Kasamatsu¹ 

[1] Department of Internal Medicine, Matsushita Memorial Hospital, 5-55, Sotojimacho, Moriguchi-shi, Osaka 570-8540, Japan;Department of Cardiovascular Medicine, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki-shi, Osaka 569-1192, Japan

关键词: Pregnancy;    Prednisolone;    Myopericarditis;    Eosinophil;    Cardiac tamponade;   

Others  :  1181190
DOI  :  10.1186/1752-1947-7-129

 received in 2012-12-17, accepted in 2013-04-11,  发布年份 2013

【 摘 要 】

Introduction

The clinical presentation of eosinophilic myocarditis may vary from asymptomatic to the manifestation of severe symptoms, including cardiac tamponade and arrhythmias. In pregnant patients with this condition, drugs must be used cautiously up to approximately the 4th month of pregnancy because drug use should be limited during the period of fetal organogenesis.

Case presentation

A 30-year-old Asian woman at 14 weeks of pregnancy with progressive malaise was hospitalized. The electrocardiogram revealed ST elevation and low QRS voltage. Echocardiography revealed massive pericardial effusion and myocardial swelling. A laboratory examination revealed an increase in her white blood cell count, with a predominance of neutrophils. Pericardial drainage was performed for relief of the cardiac tamponade. The pericardial effusion revealed an abundance of eosinophils. Subsequently, the peripheral blood eosinophil count began to rise, and the patient was clinically diagnosed with eosinophilic myopericarditis. The patient’s condition improved rapidly following the initiation of prednisolone treatment, and she finally delivered a full-term normal infant.

Conclusions

A patient with clinically suspected myopericarditis in the early stage of pregnancy who improved rapidly with pericardial drainage and prednisolone therapy, and successfully delivered a normal full-term infant; the diagnosis was made in the early stage of the disease, based on the detection of an abundance of eosinophils in the pericardial effusion preceding the subsequent development of peripheral blood eosinophilia.

【 授权许可】

   
2013 Kasamatsu et al.; licensee BioMed Central Ltd.

【 图 表 】

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