PMID- 38028083
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231201
IS  - 2050-0904 (Print)
IS  - 2050-0904 (Electronic)
IS  - 2050-0904 (Linking)
VI  - 11
IP  - 11
DP  - 2023 Nov
TI  - A rare case of tuberculous myocarditis: A diagnostic challenge in a 
      tuberculosis-endemic country.
PG  - e8224
LID - 10.1002/ccr3.8224 [doi]
LID - e8224
AB  - KEY CLINICAL MESSAGE: Tuberculous myocarditis is a rare presentation of 
      tuberculosis, posing diagnostic challenges in endemic countries. Clinicians 
      should consider this entity in patients with unexplained heart failure, 
      conduction abnormalities, or sudden cardiac events in tuberculosis-endemic 
      regions. ABSTRACT: Tuberculous myocarditis is an uncommon manifestation of 
      tuberculosis, often presenting as a diagnostic challenge, particularly in 
      tuberculosis-endemic regions. We report a case of a 58-year-old male with a 
      history of chronic cough and fever, who presented with progressive dyspnea, 
      generalized body swelling, and New York Heart Association (NYHA) Class IV heart 
      failure. Clinical examination revealed signs of cardiac decompensation and 
      congestive heart failure. Emergency echocardiography demonstrated biventricular 
      dysfunction, and imaging showed clots in both atria and the left ventricle. The 
      patient responded well to initial treatment with anticoagulants, antibiotics, 
      diuretics, and inotropic support. Subsequent investigations, including computed 
      tomography pulmonary angiogram (CTPA) and high-resolution computed tomography 
      (HRCT), confirmed active pulmonary tuberculosis. Anti-tuberculous treatment (ATT) 
      was initiated, and the patient showed remarkable improvement. The diagnosis of 
      tuberculous myocarditis was based on clinical, radiological, and laboratory 
      evidence, as cardiac biopsy was not performed due to resource limitations. 
      Tuberculous myocarditis is an underreported condition, and clinicians should be 
      vigilant about its occurrence, especially in tuberculosis-endemic regions. Early 
      recognition and prompt initiation of ATT can lead to favorable outcomes. This 
      case highlights the importance of considering tuberculous myocarditis in patients 
      with unexplained heart failure or cardiac abnormalities in areas with a high 
      burden of tuberculosis.
CI  - (c) 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
FAU - Shaikh, Ghulam Abbas
AU  - Shaikh GA
AD  - Department of Cardiology Dr. Ruth K. M. Pfau, Civil Hospital Karachi Karachi 
      Pakistan.
FAU - Yaqoob, Samina
AU  - Yaqoob S
AD  - Department of Cardiology Dr. Ruth K. M. Pfau, Civil Hospital Karachi Karachi 
      Pakistan.
FAU - Batool, Fareeha
AU  - Batool F
AD  - Department of Cardiology Dr. Ruth K. M. Pfau, Civil Hospital Karachi Karachi 
      Pakistan.
FAU - Waseem, Radeyah
AU  - Waseem R
AUID- ORCID: 0000-0002-1071-8476
AD  - Dow University of Health Sciences Karachi Pakistan.
FAU - Shah, Hussain Haider
AU  - Shah HH
AUID- ORCID: 0000-0002-8032-7462
AD  - Dow University of Health Sciences Karachi Pakistan.
FAU - Abbasi, Asim Ali
AU  - Abbasi AA
AD  - Department of Cardiology Dr. Ruth K. M. Pfau, Civil Hospital Karachi Karachi 
      Pakistan.
FAU - Lashari, Nawaz
AU  - Lashari N
AD  - Department of Cardiology Dr. Ruth K. M. Pfau, Civil Hospital Karachi Karachi 
      Pakistan.
FAU - Dave, Tirth
AU  - Dave T
AUID- ORCID: 0000-0001-7935-7333
AD  - Bukovinian State Medical University Chernivtsi Ukraine.
LA  - eng
PT  - Case Reports
DEP - 20231116
PL  - England
TA  - Clin Case Rep
JT  - Clinical case reports
JID - 101620385
PMC - PMC10654465
OTO - NOTNLM
OT  - diagnostic challenge
OT  - endemic country
OT  - myocarditis
OT  - tuberculosis
OT  - tuberculous myocarditis
COIS- The authors have no conflict of interest to declare.
EDAT- 2023/11/29 18:43
MHDA- 2023/11/29 18:44
PMCR- 2023/11/16
CRDT- 2023/11/29 17:09
PHST- 2023/08/03 00:00 [received]
PHST- 2023/10/10 00:00 [revised]
PHST- 2023/11/04 00:00 [accepted]
PHST- 2023/11/29 18:44 [medline]
PHST- 2023/11/29 18:43 [pubmed]
PHST- 2023/11/29 17:09 [entrez]
PHST- 2023/11/16 00:00 [pmc-release]
AID - CCR38224 [pii]
AID - 10.1002/ccr3.8224 [doi]
PST - epublish
SO  - Clin Case Rep. 2023 Nov 16;11(11):e8224. doi: 10.1002/ccr3.8224. eCollection 2023 
      Nov.