Acute Rheumatic Fever Presenting With Isolated Myocarditis and Right Coronary Artery Occlusion

Acute rheumatic fever (ARF) traditionally presents with carditis, usually involving valvulitis. This case report describes a 22-year-old man with an atypical ARF presentation: isolated myocarditis and coronary artery occlusion. He presented with chest pain and signs of cardiogenic shock. Initial ele...

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Bibliographic Details
Main Authors: Sumedh Iyengar, Md. Mashiul Alam, Evgeny Shkolnik, Stuart Zarich
Format: Article
Language:English
Published: American College of Physicians 2025-05-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2024.0970
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Summary:Acute rheumatic fever (ARF) traditionally presents with carditis, usually involving valvulitis. This case report describes a 22-year-old man with an atypical ARF presentation: isolated myocarditis and coronary artery occlusion. He presented with chest pain and signs of cardiogenic shock. Initial electrocardiogram and elevated cardiac biomarkers led to a diagnosis of acute myocardial infarction due to 100% right coronary artery occlusion, which was managed with wire-based thrombus removal. Further work-up revealed elevated antistreptolysin-O titers and cardiac magnetic resonance imaging consistent with myocarditis. This case highlights an occurrence of such an unusual presentation of ARF.
ISSN:2767-7664