Autoimmune Myocarditis and Arrhythmogenic Mitral Valve Prolapse: An Unexpected Overlap Syndrome

Background: both myocarditis and mitral valve prolapse (MVP) are known uncommon causes of ventricular arrhythmias in young patients. Aim: to report the first clinical case of endomyocardial biopsy (EMB)-proven autoimmune myocarditis and associated arrhythmogenic MVP in a patient with recurrent ventr...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Andrea Villatore, Simone Sala, Stefano Stella, Davide Vignale, Elena Busnardo, Antonio Esposito, Cristina Basso, Paolo Della Bella, Patrizio Mazzone, Giovanni Peretto
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	myocarditis ventricular arrhythmias mitral valve prolapse arrhythmogenic sudden cardiac death endomyocardial biopsy Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/f660035e6a734e55896f334173eff0b3
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:f660035e6a734e55896f334173eff0b3
record_format	dspace
spelling	oai:doaj.org-article:f660035e6a734e55896f334173eff0b32021-11-25T18:00:23ZAutoimmune Myocarditis and Arrhythmogenic Mitral Valve Prolapse: An Unexpected Overlap Syndrome10.3390/jcdd81101512308-3425https://doaj.org/article/f660035e6a734e55896f334173eff0b32021-11-01T00:00:00Zhttps://www.mdpi.com/2308-3425/8/11/151https://doaj.org/toc/2308-3425Background: both myocarditis and mitral valve prolapse (MVP) are known uncommon causes of ventricular arrhythmias in young patients. Aim: to report the first clinical case of endomyocardial biopsy (EMB)-proven autoimmune myocarditis and associated arrhythmogenic MVP in a patient with recurrent ventricular fibrillation (VF) episodes. Methods: myocarditis was diagnosed both by cardiac magnetic resonance (CMR) and EMB. Arrhythmogenic MVP was documented by transthoracic echocardiogram, CMR, and electroanatomical mapping of the trigger premature ventricular contractions (PVCs). Results: a 22-year-old woman underwent immunosuppressive therapy after EMB-proven diagnosis of autoimmune myocarditis with VF onset and early implantable cardioverter defibrillator (ICD) placement. Three years later, she experienced two VF recurrences and persistent PVCs, despite no signs of myocarditis recurrence. An echocardiogram revealed bileaflet MVP with high arrhythmic risk features. Finally, electroanatomical mapping and ablation of the trigger PVC were successfully performed. Conclusion: in patients with recurrent VF episodes despite evidence-based medical treatment for myocarditis, MVP should be considered as an alternative arrhythmogenic substrate, and warrants early ICD implant and PVC-targeted therapy.Andrea VillatoreSimone SalaStefano StellaDavide VignaleElena BusnardoAntonio EspositoCristina BassoPaolo Della BellaPatrizio MazzoneGiovanni PerettoMDPI AGarticlemyocarditisventricular arrhythmiasmitral valve prolapsearrhythmogenicsudden cardiac deathendomyocardial biopsyDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of Cardiovascular Development and Disease, Vol 8, Iss 151, p 151 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	myocarditis ventricular arrhythmias mitral valve prolapse arrhythmogenic sudden cardiac death endomyocardial biopsy Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	myocarditis ventricular arrhythmias mitral valve prolapse arrhythmogenic sudden cardiac death endomyocardial biopsy Diseases of the circulatory (Cardiovascular) system RC666-701 Andrea Villatore Simone Sala Stefano Stella Davide Vignale Elena Busnardo Antonio Esposito Cristina Basso Paolo Della Bella Patrizio Mazzone Giovanni Peretto Autoimmune Myocarditis and Arrhythmogenic Mitral Valve Prolapse: An Unexpected Overlap Syndrome
description	Background: both myocarditis and mitral valve prolapse (MVP) are known uncommon causes of ventricular arrhythmias in young patients. Aim: to report the first clinical case of endomyocardial biopsy (EMB)-proven autoimmune myocarditis and associated arrhythmogenic MVP in a patient with recurrent ventricular fibrillation (VF) episodes. Methods: myocarditis was diagnosed both by cardiac magnetic resonance (CMR) and EMB. Arrhythmogenic MVP was documented by transthoracic echocardiogram, CMR, and electroanatomical mapping of the trigger premature ventricular contractions (PVCs). Results: a 22-year-old woman underwent immunosuppressive therapy after EMB-proven diagnosis of autoimmune myocarditis with VF onset and early implantable cardioverter defibrillator (ICD) placement. Three years later, she experienced two VF recurrences and persistent PVCs, despite no signs of myocarditis recurrence. An echocardiogram revealed bileaflet MVP with high arrhythmic risk features. Finally, electroanatomical mapping and ablation of the trigger PVC were successfully performed. Conclusion: in patients with recurrent VF episodes despite evidence-based medical treatment for myocarditis, MVP should be considered as an alternative arrhythmogenic substrate, and warrants early ICD implant and PVC-targeted therapy.
format	article
author	Andrea Villatore Simone Sala Stefano Stella Davide Vignale Elena Busnardo Antonio Esposito Cristina Basso Paolo Della Bella Patrizio Mazzone Giovanni Peretto
author_facet	Andrea Villatore Simone Sala Stefano Stella Davide Vignale Elena Busnardo Antonio Esposito Cristina Basso Paolo Della Bella Patrizio Mazzone Giovanni Peretto
author_sort	Andrea Villatore
title	Autoimmune Myocarditis and Arrhythmogenic Mitral Valve Prolapse: An Unexpected Overlap Syndrome
title_short	Autoimmune Myocarditis and Arrhythmogenic Mitral Valve Prolapse: An Unexpected Overlap Syndrome
title_full	Autoimmune Myocarditis and Arrhythmogenic Mitral Valve Prolapse: An Unexpected Overlap Syndrome
title_fullStr	Autoimmune Myocarditis and Arrhythmogenic Mitral Valve Prolapse: An Unexpected Overlap Syndrome
title_full_unstemmed	Autoimmune Myocarditis and Arrhythmogenic Mitral Valve Prolapse: An Unexpected Overlap Syndrome
title_sort	autoimmune myocarditis and arrhythmogenic mitral valve prolapse: an unexpected overlap syndrome
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/f660035e6a734e55896f334173eff0b3
work_keys_str_mv	AT andreavillatore autoimmunemyocarditisandarrhythmogenicmitralvalveprolapseanunexpectedoverlapsyndrome AT simonesala autoimmunemyocarditisandarrhythmogenicmitralvalveprolapseanunexpectedoverlapsyndrome AT stefanostella autoimmunemyocarditisandarrhythmogenicmitralvalveprolapseanunexpectedoverlapsyndrome AT davidevignale autoimmunemyocarditisandarrhythmogenicmitralvalveprolapseanunexpectedoverlapsyndrome AT elenabusnardo autoimmunemyocarditisandarrhythmogenicmitralvalveprolapseanunexpectedoverlapsyndrome AT antonioesposito autoimmunemyocarditisandarrhythmogenicmitralvalveprolapseanunexpectedoverlapsyndrome AT cristinabasso autoimmunemyocarditisandarrhythmogenicmitralvalveprolapseanunexpectedoverlapsyndrome AT paolodellabella autoimmunemyocarditisandarrhythmogenicmitralvalveprolapseanunexpectedoverlapsyndrome AT patriziomazzone autoimmunemyocarditisandarrhythmogenicmitralvalveprolapseanunexpectedoverlapsyndrome AT giovanniperetto autoimmunemyocarditisandarrhythmogenicmitralvalveprolapseanunexpectedoverlapsyndrome
_version_	1718411779036413952

Autoimmune Myocarditis and Arrhythmogenic Mitral Valve Prolapse: An Unexpected Overlap Syndrome

Ejemplares similares