Abstract 12523: A Case of Mesalamine Induced Myopericarditis

Abstract

Myopericarditis is a condition characterized by concurrent pericarditis and myocarditis, typically with evidence of myocardial involvement detected through elevated cardiac biomarkers or imaging studies indicating abnormal systolic function. Mesalamine is a well-established first-line IBD therapy. It can pose a rare yet serious risk of cardiotoxicity that may be difficult to distinguish from myocarditis presenting as an extra-intestinal manifestation of IBD. We report a case of myopericarditis in an 18-year-old male with newly diagnosed ulcerative colitis who was recently initiated on mesalamine. He presented with chest pain exacerbated by deep inspiration, shortness of breath, fever, palpitations, and elevated troponin levels. In addition to clinical presentation, an echocardiogram indicating left ventricular systolic dysfunction, and CMR revealing edema and late epicardial gadolinium uptake aided in the diagnosis. Prompt recognition and management of cardiovascular side effects associated with mesalamine use is crucial to prevent disease progression and development of complications. Clinicians should educate patients on the possible cardiovascular side effects of mesalamine and instruct them to seek medical attention if they experience any cardiac symptoms.