An unusual interventricular septal bounce in a patient with dermatomyositis: a case report.

Vito Maurizio Parato,Michele Scarano,Andrea Di Matteo,Davide Corradini,Rami Riziq Yousef Abumuaileq,Peregrine Green,Hajnalka Vago,Mark Philip Cassar,Christian Fielder Camm,Riccardo Liga

doi:10.1093/ehjcr/ytz034

Vito Maurizio Parato, Michele Scarano + Show 8 more

Open Access

https://doi.org/10.1093/ehjcr/ytz034

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Abstract

BackgroundIn literature it has been reported in 1998, for the first time, a case of a 54-year-old man who developed constrictive pericarditis (CP) 12 years after diagnosis of dermatomyositis (DM). To our knowledge, this may be the only case reported.Case summaryA 16-year-old man presented to our institution because of symptoms posing a suspicion for an inflammatory disease; after physical examination, lab tests, and other investigations (electromyography, magnetic resonance, and muscular biopsy) was diagnosed as having DM. Patient also showed hepatomegaly and congested jugular veins: after clinical and imaging investigations (transthoracic echocardiography and transoesophageal echocardiography) he was diagnosed as having a CP. Patient underwent pericardial resection and the final outcome consisted of a completely regression of the symptoms.DiscussionCardiac involvement in patients with DM ranges between 6% and 75%, and it can be clinically manifest or, far more frequently, sub-clinic. Pericardial involvement as a complication of DM is widely reported in the literature, but in almost all cases as acute pericarditis, effusive pericarditis or cardiac tamponade and almost never as a CP.

Highlights

Dermatomyositis (DM) is a systemic idiopathic inflammatory myopathy, characterized by an inflammatory infiltrate primarily affecting skeletal muscle and skin, with typical cutaneous lesions[2] accompanying, or more often preceding, muscle weakness.The reported incidence of DM ranges from 1.2 to 17 new cases per 1 000 000 inhabitants with a prevalence between 5 and 11 cases per 100 000 individuals.[3]
Pericardial involvement as a complication of DM is widely reported in the literature, but in almost all cases as acute pericarditis, effusive pericarditis or cardiac tamponade and almost never as a constrictive pericarditis (CP)
Constrictive pericarditis may be a complication of dermatomyositis

Summary

Discussion

Cardiac involvement in patients with DM ranges between 6% and 75%, and it can be clinically manifest or, far more frequently, sub-clinic. Pericardial involvement as a complication of DM is widely reported in the literature, but in almost all cases as acute pericarditis, effusive pericarditis or cardiac tamponade and almost never as a CP. Constrictive pericarditis may be a complication of dermatomyositis. The interventricular septum bulging (or septal bounce) detected by echocardiography is the most striking finding of this type of complication

Introduction

15 January 2016 Clinical history Physical examination

Findings

Conclusion