Korean J Intern Med.  2014 Mar;29(2):236-240. 10.3904/kjim.2014.29.2.236.

Hypersensitivity myocarditis confirmed by cardiac magnetic resonance imaging and endomyocardial biopsy

• Park Y
• Ahn SG
• Ko A
• Ra SH
• Cha J
• Jee YG
• Lee JH

• KMID: 1792041
• DOI: http://doi.org/10.3904/kjim.2014.29.2.236

Abstract

Myocarditis often occurs due to viral infections and postviral immune-mediated responses. Hypersensitivity myocarditis is a rare form of myocarditis. Numerous drugs can induce myocarditis, which is typically reversible after withdrawal of the causative agent. Here, we report a case of hypersensitivity myocarditis that was probably triggered by amoxicillin and that resolved completely with heart failure management as well as discontinuation of the drug. A 68-year-old woman presented with acute chest pain mimicking acute coronary syndromes, but the coronary angiography was normal. A recent history of taking medications, skin rash, and peripheral eosinophilia suggested a diagnosis of hypersensitivity myocarditis, which was confirmed by cardiac magnetic resonance imaging and endomyocardial biopsy.

Keyword

Myocarditis; Drug hypersensitivity; Magnetic resonance imaging; Biopsy

MeSH Terms

Aged
Amoxicillin/*adverse effects
Anti-Bacterial Agents/*adverse effects
*Biopsy
Drug Hypersensitivity/*diagnosis/drug therapy/etiology/pathology
Electrocardiography
Female
Glucocorticoids/therapeutic use
Humans
*Magnetic Resonance Imaging
Myocarditis/chemically induced/*diagnosis/drug therapy/pathology
Myocardium/*pathology
Predictive Value of Tests
Prednisolone/therapeutic use
Risk Factors
Treatment Outcome
Amoxicillin
Anti-Bacterial Agents
Glucocorticoids
Prednisolone