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The Myth of Colchicine in Treating Myopericarditis: Case Report and Literature Review

Myopericarditis is inflammation of the pericardium with concurrent myocardial involvement. The clinical presentation of myopericarditis is often with varying degrees of cardiac symptomatology. Its etiology is often idiopathic, but it may also be related to infectious and inflammatory prodrome. Sympt...

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Autores principales: Al-Zakhari, Rana, Upadhya, Gautham, Galligan, Sean, Shehaj, Fiona
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392355/
https://www.ncbi.nlm.nih.gov/pubmed/32760633
http://dx.doi.org/10.7759/cureus.8933
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author Al-Zakhari, Rana
Upadhya, Gautham
Galligan, Sean
Shehaj, Fiona
author_facet Al-Zakhari, Rana
Upadhya, Gautham
Galligan, Sean
Shehaj, Fiona
author_sort Al-Zakhari, Rana
collection PubMed
description Myopericarditis is inflammation of the pericardium with concurrent myocardial involvement. The clinical presentation of myopericarditis is often with varying degrees of cardiac symptomatology. Its etiology is often idiopathic, but it may also be related to infectious and inflammatory prodrome. Symptoms are proportional to the extent and pattern of myocardial involvement. Many are diagnosed sub-clinically during the management of other systemic illnesses. Echocardiography and cardiac magnetic resonance imaging are important tools in the evaluation of myopericarditis, as the diagnosis of left ventricular dysfunction greatly affects the management, follow-up, and prognosis of these patients. The acute management of myopericarditis remains without clear direction and focuses on symptom control. The use of NSAIDs is often cautioned, as it has been described to actually accelerate the myocarditic process in animal models, possibly increasing mortality. Colchicine, a well-established anti-inflammatory agent, may have a role in the management of acute myopericarditis. We present two cases, each involving a young male, without underlying medical conditions, who presented to the emergency room with acute onset chest pain. Both were found to have elevated cardiac biomarkers and electrocardiographic (EKG) changes, admitted as in-patients and eventually diagnosed with acute myopericarditis. They made full recoveries and were eventually discharged home. Both were started on colchicine during hospitalization, which were continued for several months upon discharge. Overall, there is limited published data regarding the medical management of myopericarditis. There need to be prospective studies and registries to further our knowledge in the management of this illness.
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spelling pubmed-73923552020-08-04 The Myth of Colchicine in Treating Myopericarditis: Case Report and Literature Review Al-Zakhari, Rana Upadhya, Gautham Galligan, Sean Shehaj, Fiona Cureus Cardiology Myopericarditis is inflammation of the pericardium with concurrent myocardial involvement. The clinical presentation of myopericarditis is often with varying degrees of cardiac symptomatology. Its etiology is often idiopathic, but it may also be related to infectious and inflammatory prodrome. Symptoms are proportional to the extent and pattern of myocardial involvement. Many are diagnosed sub-clinically during the management of other systemic illnesses. Echocardiography and cardiac magnetic resonance imaging are important tools in the evaluation of myopericarditis, as the diagnosis of left ventricular dysfunction greatly affects the management, follow-up, and prognosis of these patients. The acute management of myopericarditis remains without clear direction and focuses on symptom control. The use of NSAIDs is often cautioned, as it has been described to actually accelerate the myocarditic process in animal models, possibly increasing mortality. Colchicine, a well-established anti-inflammatory agent, may have a role in the management of acute myopericarditis. We present two cases, each involving a young male, without underlying medical conditions, who presented to the emergency room with acute onset chest pain. Both were found to have elevated cardiac biomarkers and electrocardiographic (EKG) changes, admitted as in-patients and eventually diagnosed with acute myopericarditis. They made full recoveries and were eventually discharged home. Both were started on colchicine during hospitalization, which were continued for several months upon discharge. Overall, there is limited published data regarding the medical management of myopericarditis. There need to be prospective studies and registries to further our knowledge in the management of this illness. Cureus 2020-06-30 /pmc/articles/PMC7392355/ /pubmed/32760633 http://dx.doi.org/10.7759/cureus.8933 Text en Copyright © 2020, Al-Zakhari et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Al-Zakhari, Rana
Upadhya, Gautham
Galligan, Sean
Shehaj, Fiona
The Myth of Colchicine in Treating Myopericarditis: Case Report and Literature Review
title The Myth of Colchicine in Treating Myopericarditis: Case Report and Literature Review
title_full The Myth of Colchicine in Treating Myopericarditis: Case Report and Literature Review
title_fullStr The Myth of Colchicine in Treating Myopericarditis: Case Report and Literature Review
title_full_unstemmed The Myth of Colchicine in Treating Myopericarditis: Case Report and Literature Review
title_short The Myth of Colchicine in Treating Myopericarditis: Case Report and Literature Review
title_sort myth of colchicine in treating myopericarditis: case report and literature review
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392355/
https://www.ncbi.nlm.nih.gov/pubmed/32760633
http://dx.doi.org/10.7759/cureus.8933
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