Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2022; 10(36): 13451-13457
Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13451
Development of dilated cardiomyopathy with a long latent period followed by viral fulminant myocarditis: A case report
Seung Do Lee, Hyo Jin Lee, Hye Ree Kim, Min Gyu Kang, Kyehwan Kim, Jeong Rang Park
Seung Do Lee, Hyo Jin Lee, Hye Ree Kim, Min Gyu Kang, Kyehwan Kim, Jeong Rang Park, Division of Cardiology, Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727, South Korea
Author contributions: Park JR was the patient’s cardiologist, reviewed the literature, and contributed to the critical revision of the manuscript; Lee SD reviewed the literature, interpreted the clinical findings, and contributed to the manuscript’s drafting; Kang MG, Kim K, Lee HJ, and Kim HR contributed to the manuscript drafting; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jeong Rang Park, MD, PhD, Professor, Division of Cardiology, Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 79 Gangnam-ro, Jinju 52727, South Korea. parkjrang@gmail.com
Received: September 26, 2022
Peer-review started: September 26, 2022
First decision: October 28, 2022
Revised: November 10, 2022
Accepted: December 5, 2022
Article in press: December 5, 2022
Published online: December 26, 2022
Abstract
BACKGROUND

The clinical course of acute myocarditis ranges from the occurrence of a few symptoms to the development of fatal fulminant myocarditis. Specifically, fulminant myocarditis causes clinical deterioration very rapidly and aggressively. The long-term prognosis of myocarditis is varied, and it fully recovers without leaving any special complications. However, even after recovery, heart failure may occur and eventually progress to dilated cardiomyopathy (DCM), which causes serious left ventricular dysfunction. In the case of follow-up observation, no clear guidelines have been established.

CASE SUMMARY

We report the case of a 21-year-old woman who presented with dyspnea. She became hemodynamically unstable and showed sustained fatal arrhythmias with decreased heart function. She was clinically diagnosed with fulminant myocarditis based on her echocardiogram and cardiac magnetic resonance results. After 2 d, she was readmitted to the emergency department under cardiopulmonary resuscitation and received mechanical ventilation and extracorporeal membrane oxygenation. An implantable cardioverter defibrillator was inserted for secondary prevention. She recovered and was discharged. Prior to being hospitalized for sudden cardiac function decline and arrhythmia, she had been well for 7 years without any complications. She was finally diagnosed with dilated cardiomyopathy.

CONCLUSION

DCM may develop unexpectedly in patients who have been cured of acute fulminant myocarditis and have been stable with a long period of remission. Therefore, they should be carefully and regularly observed clinically throughout long-term follow-up.

Keywords: Myocarditis, Fulminant, Dilated cardiomyopathy, Outcome, Remission, Case report

Core Tip: While dilated cardiomyopathy (DCM) has been well-known as a complication in patients who develop fulminant myocarditis, it is still unclear when DCM might occur. We report the case of a young woman who developed DCM after 7 years of remission without any special complications after recovering from viral myocarditis. No case of DCM development has been reported after such a long latent period of normal cardiac function after a full recovery from viral fulminant myocarditis. We, therefore, suggest that clinicians be aware that DCM can develop unexpectedly and that careful clinical monitoring is required regularly.