Open AccessFatal myopericarditis complicated with coronary vein perforation under the triple antithrombotic therapy: a case report
Author(s) -
Akihisa Takasaki,
Ryuji Okamoto,
Hiroko Sugimoto,
Kaoru Dohi
Publication year - 2021
Publication title -
european heart journal. case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.256
H-Index - 5
ISSN - 2514-2119
DOI - 10.1093/ehjcr/ytab098
Subject(s) - medicine , cardiac tamponade , myopericarditis , pericarditis , pericardial effusion , antithrombotic , surgery , cardiac rupture , acute pericarditis , complication , chest pain , cardiology , acute coronary syndrome , autopsy , tamponade , myocardial infarction
Background Acute pericarditis generally follows a mild clinical course and is rarely fatal. Coronary vein involvement is rarely reported. Case summary We report an autopsy case of cardiac tamponade from idiopathic myopericarditis due to coronary venous perforation under the triple antithrombotic therapy. A 69-year-old man was admitted to our hospital with abnormal findings on electrocardiography, bloody pericardial effusion, and mild elevation of troponin I. Oral anti-inflammatories were started and the patient followed a benign course. However, on hospital Day 5, he suddenly suffered cardiogenic shock with pulseless electric activity due to cardiac tamponade under the combination use of the dual antiplatelet drugs and an anticoagulant drug. He died despite intense medical treatment. Autopsy revealed cardiac tamponade caused by perforation in the coronary venous wall. To the best of our knowledge, this is the first description of fatal myopericarditis as a complication of coronary venous perforation. Discussion The aetiology and mechanism remain unknown; however, we should take care for this rare complication in patients with acute myopericarditis and bloody effusion under the triple antithrombotic therapy.