Viral Myocarditis in the Setting of Delayed Manifestation of Hamman-Rich Syndrome

• Published in: Curēus (Palo Alto, CA) Vol. 15; no. 2; p. e34916
• Main Authors: Kabra, Ruchita, Kumar, Sunil, Acharya, Sourya, Bhansali, Pratik J, Daiya, Varun
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 13.02.2023; Cureus
• Subjects: Blood; Cardiac arrhythmia; Case reports; Coronaviruses; COVID-19; Dyspnea; Illnesses; Influenza; Internal Medicine; Medical diagnosis; Mortality; Myocarditis; Patients; Pneumonia; Pulmonology; Radiology; Respiratory failure; Thorax; Ventilators; acute respiratory distress syndrome; diagnosis; pulmonary; rapidly progressive; interstitial
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.34916

Acute respiratory distress syndrome (ARDS)-like symptoms and rapid progression characterize the interstitial lung disease known as acute interstitial pneumonitis, also known as Hamman-Rich syndrome. It has a bad prognosis and a high incidence of mortality. We describe the case of a 25-year-old male patient with acute-onset type I respiratory failure with detrimental X-ray abnormalities who presented to the emergency room without any history of pulmonary disease or smoking. The provisional diagnosis of Hamman-Rich syndrome was reached after other clinical entities were ruled out based on CT findings. Myocardial hypokinesis of the apex and septum, as well as a modest systolic dysfunction (ejection fraction: 50%) similar to acute myocarditis, were detected by echocardiogram. Acute myocarditis in the setting of Hamman-Rich syndrome has been anecdotally reported and its mechanism remains to be elucidated.