Sikawat Thanaviratananich1, Bashar Katirji, Amer Alshekhlee. 1. *Department of Neurology, SSM Neurosciences Institute and St. Louis University, St. Louis, MO; and †Neurological Institute, University Hospitals Case Medical Center, Cleveland, OH.
Abstract
OBJECTIVES: Myocardial pathology is rarely associated with myasthenia gravis (MG). We describe a case of newly diagnosed MG with decompensated heart failure [stress-induced cardiomyopathy (SICM)] that occurred during the crisis phase. METHODS: Case report and review of literature. RESULTS: A 42-year-old woman underwent chemotherapy followed by a transsternal resection of a malignant epithelioid thymoma invading the pericardium. A month after surgical resection, she developed progressive oropharyngeal symptoms with respiratory distress requiring tracheal intubation. Cardiac evaluation on the day of admission showed a normal ejection fraction, which rapidly decreased to 15% on the second hospital day and recovered to 45% after 1 week. Review of the literature revealed 4 myasthenic patients who developed SICM in the crisis phase; all improved with treatment. CONCLUSIONS: SICM may occur in MG crisis, especially in the presence of malignant thymoma. All previous cases including our patient had improved myocardial function and clinical outcomes.
OBJECTIVES: Myocardial pathology is rarely associated with myasthenia gravis (MG). We describe a case of newly diagnosed MG with decompensated heart failure [stress-induced cardiomyopathy (SICM)] that occurred during the crisis phase. METHODS: Case report and review of literature. RESULTS: A 42-year-old woman underwent chemotherapy followed by a transsternal resection of a malignant epithelioid thymoma invading the pericardium. A month after surgical resection, she developed progressive oropharyngeal symptoms with respiratory distress requiring tracheal intubation. Cardiac evaluation on the day of admission showed a normal ejection fraction, which rapidly decreased to 15% on the second hospital day and recovered to 45% after 1 week. Review of the literature revealed 4 myasthenicpatients who developed SICM in the crisis phase; all improved with treatment. CONCLUSIONS: SICM may occur in MG crisis, especially in the presence of malignant thymoma. All previous cases including our patient had improved myocardial function and clinical outcomes.
Authors: Taylor M Douglas; Perry Wengrofsky; Syed Haseeb; Eric Kupferstein; Pramod Theetha Kariyanna; Jacob Schwartz; Louis Salciccioli; Samy I McFarlane Journal: Am J Med Case Rep Date: 2018-10-11
Authors: Pramod Theetha Kariyanna; Bayu Sutarjono; Apoorva Jayarangaiah; Remi Okwechime; Amog Jayarangaiah; Perry Wengrofsky; Isabel M McFarlane Journal: Am J Med Case Rep Date: 2019-07-19