Epstein-Barr Virus Associated Myopericarditis Presenting as Generalized Anxiety

Abstract

Background: This case highlights the importance of motivational interviewing in a rare condition with comorbid psychiatric symptomology. Epstein-Barr Virus (EBV) induced myopericarditis has not been described in a healthy young woman. Her anxiety symptoms complicated the diagnosis of this condition. Case presentation: Ms. A is an otherwise healthy 26-year-old female with a history of generalized anxiety disorder. She presented to the emergency department with anxiety and a sense of impending doom. Her family history is positive for hypertension and unspecified mental health issues. She refused workup due to panic symptoms but was persuaded through motivational interviewing. Eventual cardiac MRI revealed viral induced myopericarditis. The outcome was both resolution of her cardiovascular and psychiatric symptomology. Conclusion: The implications of this case report is the value of addressing psychological resistance to pathophysiological workup. Once her concerns were addressed through psychological and psychopharmacological methods, a rare cardiovascular disorder was identified and treated. The lesson for healthcare providers is that nonjudgmental interviewing can lead to the diagnosis of very uncommon diseases.