Case Report
Copyright ©The Author(s) 2022.
World J Clin Cases. Sep 26, 2022; 10(27): 9750-9759
Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9750
Table 1 Summary of reported cases describing myocarditis as an extraintestinal manifestation of inflammatory bowel disease
IBD type
Clinical presentation
Myocarditis treatment
Recurrence/other info
Frid et al[22], 1986Male/11CDMyocarditisFever (38 °C), fatigue, dyspnea on exertionRaised ESR; ST-segment depression (ECG)SteroidsImprovedEIM earlier than GI symptoms
Weiss et al[23], 1995Male/44CDMyocarditisFatigue, dyspnea on exertion symptoms of congestive heart failureWBC 15.2, ESR 64, CRP 64.2; ST-T segment flattening (ECG); cardiomegaly (CXR); LVEF 30%, left heart enlargement with regional hypokinesia (echo)Steroids + olsalazineImprovedSubcutaneous granulomas; EIM earlier than GI symptom
Hyttinen et al[24], 2003Female/37CDMyopericarditisChest pain, palpitations, dyspnea on exertion loss of consciousness, convulsionsCRP 149; third-degree AV block, ST-segment elevation T-wave inversion (ECG); pericardial effusion (echo); normal (EMB)Atropine + PPMImproved5 × recurrences; GI symptom (-)
Nishtar et al[25], 2009Female/21CDMyocarditisFever (37.5 °C), dyspnea, symptoms of pulmonary edema, hemodynamically unstableWBC 21, CRP 234; TnI 0.48; diffuse T-wave inversion (ECG); pulmonary edema (CXR); LVEF 16%, dilation of ventricles with global hypokinesia (echo)ICU + ventilatory and inotropic support mesalamineImprovedAfter limited hemicolectomy
Sikkens et al[26], 2010Male/46CDMyopericarditisFever (38.5 °C), tachypnea cardiac arrestWBC 12, ESR 22; unremarkable ventricular fibrillation (ECG); lymphocytic infiltration (autopsy)CPRDied
Williamson and Dalton[27], 2011Male/18CDMyocarditisShock, tachypnea, hypoxicRaised CRP; pulmonary edema (CXR); RBBB LVEF 20%, LV failure (echo)Subtotal colectomy + ventilatory and inotropic supportImproved
Oh et al[28], 2012Female/19CDMyocarditisFever (41.0 °C), headache, myalgia impaired consciousness, shock, respiratory failureWBC 21.44, CRP 92.9; TnI 5.32; sinus tachycardia (ECG); pulmonary edema (CXR); LVEF 38%, dilation of ventricles with LV regional akinesia (echo)ICU + inotropic support steroid + mesalamineImproved
Belin et al[29], 2016Female/56CDMyocarditisPleuritic chest pain radiating to the back and shouldersWBC 13.7, ESR 47, CRP 22.7; TnI 1.14-1.63, BNP 166; LV hypertrophy (ECG); pleural effusion (CXR); LVEF 45-50%, regional hypokinesia (scho); regional DGE, elevated ECV (CMR)Infliximab steroidsImproved
Kumar et al[30], 2019Male/37CDMyopericarditisPleuritic chest pain, dry cough, fever (38.1 °C)WBC 26.2, ESR 121, CRP 180.1; TnI 1.82; ST-segment elevation (ECG); regional EGE and DGE with edema (CMR)Steroids + colchicineImprovedP.M. stress cardiomyopathy
McGrath-Cadell et al[31], 2020Female/27CDMyopericarditisPleuritic chest pain, fever (39 °C), dyspnea, hemodynamically unstableWBC 21, CRP 115; TnI 9; T-wave inversion (ECG); regional thickening and hypokinesia, mobile valvular masses (echo); focal edema with DGE (CMR)Steroids + colchicine + AZAImproved2 × recurrences; P.M. monocular visual loss and sterile splenic abscesses; GI symptoms (-)
Mowat et al[32], 1974Male/15UCMyopericarditisRetrosternal discomfort, feverRaised ESR; sinus tachycardia, ST-segment abnormality, T-wave inversion (ECG)Steroids + sulphasalazineImproved4 × recurrences; renal calculus
McKeon et al[33], 1986Female/17UCMyocarditisCardiac arrest, hypotensive, peripheral edemaPleural effusion (CXR); sinus tachycardia with incomplete RBBB tachyarrhythmias (ECG); LVEF 23%, RV dilation (echo); giant cell collection (autopsy)ICU + inotropic supportDiedAfter total colectomy, PTN
Frid et al[22], 1986Male/19UCMyocarditisFatigue, dyspnea heart failure, arrythmiaESR 10; cardiomegaly, pleural effusion (CXR); heart little movement (echo)ICU + steroidsImprovedUrticaria; GI symptoms (-)
Stajer and Gorjup[34], 1996Female/17UCMyopericarditisChest pain, tachycardia, dyspnea, hypotensive, hypoxic, enlarged liver and spleenESR 72; S1Q3, R-wave progression (ECG); cardiomegaly, bilateral effusion (CXR); pericardial effusion, RV enlargement (echo)ICU + mesalamineImprovedPleuritis, DVT
Nash et al[35], 2001Male/46UCMyocarditisChest pain, tachycardia, hypotensive, tachypnea; gallop rhythm, hepatojugular reflux (+)WBC 18.6; ST-segment elevation (ECG); LVEF 19%, global hypokinesia (echo); giant cells with necrosis (EMB)ICU + inotropic support + IABP + steroids + immunoglobulin + CsA + etanercept + AZADiedP.M. ITP
Freeman and Salh[36], 2010Male/26UCMyopericarditisPleuritic chest pain radiating to the shoulder and neck, fever, tachycardia, lethargyWBC normal; TnI 4.82; atrial flutter with 2:1 block non-specific ST-T wave change (ECG)Steroids + mesalamineImproved2 × recurrences, EIM before GI symptoms
Varnavas et al[37], 2014Male/30UCMyocarditisSymptoms of left heart failureWBC 16.3, CRP 276; TnI 7.6, BNP 4745; sinus tachycardia, non-specific ST-T wave changes (ECG); LVEF 13%, regional hypokinesia, pericardial effusion (echo); focal edema (CMR); lymphocytic infiltration (EMB)ICU + inotropic support + IABP + steroids + mesalamineImproved2 × recurrences
Gruenhagen et al[38], 2014Male/24UCMyocarditisChest pain radiating to the arms, dyspnea, diaphoresis, dizzinessTnI 0.211-1.57 (ref < 0.034); ST-segment elevation (ECG); DGE (CMR)Ssteroid + mesalamineImproved
Kim et al[39], 2016Female/28UCMyocarditisDyspneaTnI 0.512; sinus tachycardia, non-specific ST-segment change (ECG); cardiomegaly, pulmonary congestion (CXR); LVEF 33%, LV hypokinesia and dilation (echo)ECMO + steroid + infliximabImproved
Murphy et al[40], 2017Male/42UCMyocarditisSymptoms of heart failureBNP 4987; non-specific T-wave changes (ECG); pulmonary edema, pleural effusion (CXR); LVEF 29%, LV global hypokinesia, pericardial effusion (echo); focal DGE (CMR); eosinophilic infiltration, fibrosis (EMB)Steroids + ICDImproved
Caio et al[41], 2021Male/26UCMyocarditisChest pain, tachycardiaWBC 15.2, CRP 32.1; raised TnI; normal (ECG); focal edema (CMR)Steroids + vedolizumabImproved2 × recurrences