Heart Failure From Gouty Myocarditis: A Case Report

Letters3 March 2020Heart Failure From Gouty Myocarditis: A Case ReportAndrea Frustaci, MD, Matteo Antonio Russo, MD, Luigi Sansone, PhD, Marco Francone, MD, PhD, Romina Verardo, PhD, Claudia Grande, PhD, Maria Alfarano, MD, and Cristina Chimenti, MD, PhDAndrea Frustaci, MDSapienza University and IRCCS L. Spallanzani, Rome, Italy (A.F., C.C.), Matteo Antonio Russo, MDSan Raffaele Open University and IRCCS San Raffaele Pisana, Rome, Italy (M.A.R.), Luigi Sansone, PhDIRCCS San Raffaele Pisana, Rome, Italy (L.S.), Marco Francone, MD, PhDSapienza University, Rome, Italy (M.F., M.A.), Romina Verardo, PhDIRCCS L. Spallanzani, Rome, Italy (R.V., C.G.), Claudia Grande, PhDIRCCS L. Spallanzani, Rome, Italy (R.V., C.G.), Maria Alfarano, MDSapienza University, Rome, Italy (M.F., M.A.), and Cristina Chimenti, MD, PhDSapienza University and IRCCS L. Spallanzani, Rome, Italy (A.F., C.C.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0486 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Myocarditis is an important cause of heart failure, and successful treatment depends on identifying the underlying cause and mechanism. Infectious and autoimmune diseases are the most common causes, although myocarditis can also be caused by endocrine disorders, such as pheochromocytoma (1); infiltrative disorders, such as amyloidosis (2); and metabolic disorders. Gout is a metabolic disorder characterized by increased uric acid in the blood and the deposition of amorphous urate crystals that cause a vigorous inflammatory reaction in the joints, kidneys, and soft tissues. Urate crystals have been found in coronary vessels and cardiac valves but, to our knowledge, not ...References1. Van Vliet PD, Burchell HB, Titus JL. Focal myocarditis associated with pheochromocytoma. N Engl J Med. 1966;274:1102-8. [PMID: 5932021] CrossrefMedlineGoogle Scholar2. Lim HE, Pak HN, Kim YH. Acute myocarditis associated with cardiac amyloidosis manifesting as transient complete atrioventricular block and slow ventricular tachycardia [Letter]. Int J Cardiol. 2006;109:395-7. [PMID: 15964086] CrossrefMedlineGoogle Scholar3. Park JJ, Roudier MP, Soman D, et al. Prevalence of birefringent crystals in cardiac and prostatic tissues, an observational study. BMJ Open. 2014;4:e005308. [PMID: 25031195] doi:10.1136/bmjopen-2014-005308 CrossrefMedlineGoogle Scholar4. Chimenti C, Frustaci A. Contribution and risks of left ventricular endomyocardial biopsy in patients with cardiomyopathies: a retrospective study over a 28-year period. Circulation. 2013;128:1531-41. [PMID: 24004501] doi:10.1161/CIRCULATIONAHA.13.001414 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Sapienza University and IRCCS L. Spallanzani, Rome, Italy (A.F., C.C.)San Raffaele Open University and IRCCS San Raffaele Pisana, Rome, Italy (M.A.R.)IRCCS San Raffaele Pisana, Rome, Italy (L.S.)Sapienza University, Rome, Italy (M.F., M.A.)IRCCS L. Spallanzani, Rome, Italy (R.V., C.G.)Financial Support: By grant JTC 2016 IKDT-IGCM from the European Research Area Network on Cardiovascular Diseases under European Project ERA-CVD "Transnational Research Projects on Cardiovascular Diseases" and by Italian Ministry of Health (Ricerca Corrente) funds given to IRCCS L. Spallanzani and IRCCS San Raffaele Pisana.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0486.This article was published at Annals.org on 3 December 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAn uncommon presentation of cutaneous dissemination of goutNew Insights in Human MyocarditisWhat Has Dual Energy CT Taught Us About Gout?Urate Crystals; Beyond JointsSystemic Urate Deposition: An Unrecognized Complication of Gout? 3 March 2020Volume 172, Issue 5Page: 363-365KeywordsAllopurinolBiopsyElectron microscopyGoutHeart failureHistologyMyocarditisMyocardiumSoft tissuesUric acid ePublished: 3 December 2019 Issue Published: 3 March 2020 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...