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Association of endomyocardial fibrosis and minor myocarditis sequelae with intracardiac thrombus and Ebstein like valvulopathy in a patient with Behçet disease: a case report.
Ceruti, Hélène; van de Borne, Philippe; Mirica, Daniela-Corina.
Afiliación
  • Ceruti H; Department of Cardiology, Hopital Universitaire de Bruxelles (HUB), Route de Lennik, Hopital Erasme, Route de Lennik 808, 1070 Anderlecht, Bruxelles, Belgium.
  • van de Borne P; Department of Cardiology, Hopital Universitaire de Bruxelles (HUB), Route de Lennik, Hopital Erasme, Route de Lennik 808, 1070 Anderlecht, Bruxelles, Belgium.
  • Mirica DC; Department of Cardiology, Hopital Delta, Boulevard du Triomphe Hopital Delta, Boulevard du Triomphe 201, 1160 Auderghem, Bruxelles, Belgium.
Eur Heart J Case Rep ; 8(1): ytad631, 2024 Jan.
Article en En | MEDLINE | ID: mdl-38173783
ABSTRACT

Background:

Cardiac complications occur in 1-6% of cases of Behçet disease (BD) with intracardiac thrombus being the most frequent complication. Endomyocardial fibrosis, less common and occasionally associated with intracardiac thrombus, is reported in <20 case reports of BD, among which, three cases are described to mimic Ebstein disease based on echocardiography. We present the first case in the literature of a 34-year-old man with BD diagnosed with multiple cardiovascular complications, highlighting the challenging diagnosis and treatment of this pathology, especially regarding anticoagulation therapy. Case

summary:

A 34-year-old man, diagnosed with BD, presented to the Emergency Room with haemoptysis. Computed tomography study of the thorax diagnosed pulmonary arterial aneurysm with multiple arterial thrombi, associated with multiple intracardiac thrombi in the right ventricle and atrium. The echocardiography confirmed the presence of voluminous thrombi in the right ventricle and atrium and showed hypertrabeculation of the right ventricle and a high insertion of the posterior leaflet of the tricuspid valve inducing a moderate tricuspid insufficiency compatible with an Ebstein disease. The cardiac MRI later revealed right ventricular fibrosis consistent with endomyocardial fibrosis and sequelae of myocarditis, also described as BD rare cardiac manifestations. The patient had a favourable outcome under anticoagulant treatment and immunosuppressive drugs.

Discussion:

The association of multiple cardiovascular complications can occur in a single patient with BD. The endomyocardial fibrosis in the right heart chambers acting as a substrate for thrombus formation and subsequent pulmonary embolism; fibrosis extending to the tricuspid valve inducing an Ebstein-like morphology.
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Risk_factors_studies Idioma: En Revista: Eur Heart J Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Risk_factors_studies Idioma: En Revista: Eur Heart J Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Reino Unido