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De novo atrial fibrillation and acute myocarditis

Fibrilación auricular de novo y miocarditis aguda




Section
Case Reports

How to Cite
Buitrago Gómez, N., Herrera Escandón, Álvaro . ., Uribe Posso, L. P. ., Quiñonez Calvache , C. ., Ramírez Solarte, Ángela ., & Zambrano Castro, S. . (2023). De novo atrial fibrillation and acute myocarditis. Journal of Medicine and Surgery Repertoire, 32(2), 173-178. https://doi.org/10.31260/RepertMedCir.01217372.1177

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Nathalia Buitrago Gómez

    Álvaro Herrera Escandón

      Laura Patricia Uribe Posso

        Steven Zambrano Castro


          Nathalia Buitrago Gómez,

          Residente de Medicina Interna, Universidad Libre seccional Cali


          Álvaro Herrera Escandón,

          Médico internista. Cardiólogo. DIME Cínica Neurocardiovascular. Profesor Asistente Profesor asistente, Departamento de Medicina Interna. Universidad del Valle.


          Laura Patricia Uribe Posso,

          Médica Internista. Cardióloga DIME Clínica Neurocardiovascular. Cali, Colombia. Profesora Auxiliar. Universidad Libre Seccional Cali.


          Ángela Ramírez Solarte,

          Residente de Medicina Interna. Universidad Libre seccional Cali.


          Introduction:  myocarditis (MCT) is characterized by an inflammatory infiltration into the myocardium associated with degeneration and/or necrosis. Its etiologies include multiple bacteria, toxins, and autoimmune diseases among others. But most commonly it is induced by viruses. Diagnosis is challenging due to its variable presentation, imaging, and laboratory results. Objective: to describe two cases of myocarditis which debuted with atrial fibrillation as an unusual manifestation. Methodology: two cases were registered in Cali, Colombia, with myocarditis diagnosed by contrasted cardiovascular magnetic resonance imaging (cMRI). Cases: the first case corresponds to a 66-year-old female patient with a history of diabetes and hypothyroidism who was admitted for a syncope episode. The second case is a 43-year-old male with chest pain and a negative medical history. Atrial fibrillation (AF) and acute MCT were documented by cMRI. Patients received medical treatment and evolved satisfactorily presenting no cardiac failure at follow-up. Discussion and conclusions: these cases show the heterogeneity of acute MCT clinical manifestations and the importance of suspecting MCT in the presence of de novo AF. Diagnosis may be delayed in our setting due to the lack of access to cMRI, which has become a fundamental tool to distinguish MCT from other life-threatening conditions, such as myocardial ischemia, which also elevate markers such as ultrasensitive troponin.


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