Dynamic Compression of the Left Coronary Artery by a Left Ventricular Pseudoaneurysm after Myocarditis.

UNLABELLED: A 69-year-old man with a recent diagnosis of suspected leptospirosis infection-related myocarditis presented with antecedent arthralgia, myalgia, fever, intermittent anterior chest pain, yellowish sclera, yellowish skin and shortness of breath. His symptoms improved after antibiotic treatment with penicillin for 14 days. However, recurrent chest pain and progressive dyspnea upon exertion developed 2 months later. A newly developed left ventricular outflow tract pseudoaneurysm was identified by cardiac sonography and multi-detector computed tomography of the heart. A subsequent coronary arteriogram demonstrated an left ventricular (LV) pseudoaneurysm causing compression to both the left circumflex coronary artery and the left anterior descending coronary artery with significant stenosis. To the best of our knowledge, this is the first reported case of a LV pseudoaneurysm developing after a clinical course of suspected leptospirosis-related myocardit is causing dynamic compression of the left coronary artery. KEY WORDS: Dynamic compression of coronary artery; Left ventricular pseudoaneurysm; Leptospirosis; Myocarditis.