Miocarditis aguda por alcohol que imita un síndrome coronario agudo

Dr. Kendall Ramírez Sanabria
Médico General. Universidad de Costa Rica.
Departamento de Fisiología de la Universidad de Costa Rica.
Miembro del Colegio de Médicos y Cirujanos de Costa Rica.
Costa Rica.

Resumen

La miocarditis es una enfermedad inflamatoria del miocardio que puede ser causada por infecciones virales o bacterianas, mecanismos autoinmunes, tóxicos y reacciones de hipersensibilidad a fármacos. Se puede presentar como dolor torácico con elevación de marcadores de daño miocárdico, insuficiencia cardiaca o arritmias. En este artículo, se presenta el caso de una paciente femenina de 38 años con antecedente de dos semanas de abuso de alcohol, quien presentaba dolor torácico de una semana de evolución, elevación de la troponina T ultrasensible, cambios dinámicos de la onda T y datos ecocardiográficos de insuficiencia cardiaca. En la coronariografía, no se encontraron lesiones obstructivas, y en la resonancia magnética cardiaca se observó un patrón de miocarditis, por lo que se realizó el diagnóstico de miocarditis aguda y se inició el tratamiento adecuado. A partir de este, la paciente evolucionó de manera favorable.

Palabras claves

Miocarditis, alcohol, síndrome coronario.

Abstract

Myocarditis is an inflammatory myocardial disease caused by bacterial or viral infections, autoimmune diseases, toxics and hypersensitivity reactions to drugs. It can present as thoracic pain and elevation of myocardial injury biomarkers, heart failure or arrhythmias. In this article, we present the case of a 38 years old female who reported alcohol binge drinking during the previous two weeks, who complained of thoracic pain, had elevation of high-sensitive troponin T, dynamic changes of T wave and echography findings of heart failure. Coronary angiography did not showed obstructive lesions and cardiac magnetic resonance showed a myocarditis pattern, therefore we made the diagnosis of acute myocarditis and initiated the appropriate treatment. The patient had an optimal clinical evolution.

Keywords

Myocarditis, alcohol, coronary syndrome.

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