Isolated Right Ventricular Myocarditis: Rarely Reported Pathology

Abstract

Objective. Preventing the morbidity and mortality from isolated right ventricular myocarditis by its early recognition and treatment. Background. The clinical presentation of myocarditis ranges from nonspecific systemic symptoms (fever, myalgia, palpitations, or exertional dyspnea) to fulminant cardiac failure and sudden death. In our case, echocardiography raised the possibility of myocarditis at an early stage, although the signs and symptoms did not indicate right ventricular disease. Review of the literature showed only 4 previous reports, all diagnosed at autopsy, in which diagnosis was not suspected in vivo. Design/Methods. We are reporting case of a 23-year-old male with no past medical history who presented to emergency room with a nonexertional sharp left sided chest pain. Diagnostic tests were conducted, which revealed elevated troponins, decreased right ventricular ejection function but preserved left ventricular function, and no evidence of coronary artery disease. Results. A diagnosis of isolated right ventricular myocarditis was made on the basis of clinical, echocardiographic, and cardiac MRI findings. Conclusions. Isolated right ventricular myocarditis should be suspected in a patient with depressed right ventricular function without left ventricular involvement on echocardiography and cardiac MRI, elevated cardiac enzymes, and no evidence of coronary artery disease.