The Velvet Myocardium: Potential Harbinger of Death in Acute Myocarditis?

Abstract A case of fulminant myocarditis in a young man is described. Bedside hand-held focused cardiac ultrasound demonstrated severe systolic dysfunction with hypertrophied myocardium. Echocardiogram showed a speckled texture of the myocardium and a “velvet-like” appearance. Unfortunately, the pat...

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Bibliographic Details
Published inCanadian journal of cardiology Vol. 29; no. 12; pp. 1742.e25 - 1742.e27
Main Authors Johri, Amer M., MD, FASE, FRCPC, Barake, Walid, MD, MBBCh, Crawford, Bredon, MASc, Turashvili, Gulisa, MD, PhD, Rossiter, John, MD, PhD, Evans, Gerald A., MD, FRCPC
Format Journal Article
LanguageEnglish
Published England Elsevier Inc 01.12.2013
Subjects
Acute Disease
Adult
Cardiovascular
Disease Progression
Echocardiography
Fatal Outcome
Heart Failure, Systolic - pathology
Histiocytes - pathology
Histiocytosis - pathology
Humans
Hypertrophy, Left Ventricular - pathology
Lymphocytes - pathology
Lymphocytosis - pathology
Male
Muscle Cells - pathology
Myocarditis - pathology
Myocardium - pathology
Ontario
Prognosis
Shock, Cardiogenic - pathology
Ontario
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Summary:Abstract A case of fulminant myocarditis in a young man is described. Bedside hand-held focused cardiac ultrasound demonstrated severe systolic dysfunction with hypertrophied myocardium. Echocardiogram showed a speckled texture of the myocardium and a “velvet-like” appearance. Unfortunately, the patient developed cardiogenic shock and despite aggressive management, he died. The autopsy showed multifocal lymphohistiocytic infiltration and myocyte injury. We propose that the “velvet” myocardial ultrasonic appearance with ventricular hypertrophy is an indicator of rapid clinical demise.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
ObjectType-Article-3
ISSN:0828-282X
1916-7075
DOI:10.1016/j.cjca.2013.09.007