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European Heart Journal 1990 11(10):960-963;
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

A loud third heart sound and asymptomatic myocarditis during Mycoplasma pneumoniae infection

J. KARJALAINEN

Central Military Hospital Helsinki, Finland

Received 21 August 1989; revised 23 November 1989; .

Correspondence: Dr Jouko Karjalainen, Central Military Hospital, PL 50, 00301 Helsinki 30, Finland.

Abstract

A 20-year-old man had a fever and cough due to Mycoplasma pneumoniae pneumonia. He had no heart symptoms, but auscultation revealed an exceptionally loud third heart sound, suggesting cardiac involvement. Marked myocardial enzyme release, serial electrocardiographic ST-T changes, and transient increase in interventricular thickness and inferior wall hypokinesis at echocardiography supported the diagnosis of acute infectious myocarditis. Recovery was quick. This case shows that acute myocarditis with significant myocardial injury may pass without any subjective heart symptoms

Key Words: Myocarditis • Mycoplasma pneumoniae • third heart sound


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