Myocarditis is inflammation of the cardiac muscle. The symptoms, signs and basic investigation findings can mimic that of myocardial infarction. The most common cause is infection (most commonly viral). Cardiovascular magnetic resonance (CMR) is the gold standard non-invasive diagnostic test for potential acute myocarditis as it allows assessment of myocardial oedema and scar. A man aged 25 years was admitted with chest pain, dizziness, headache, palpitations and sweating. His troponin was mildly positive. A CMR was performed which showed mild myocarditis and a right suprarenal mass which was confirmed to be a phaeochromocytoma based on biochemistry and a dedicated imaging workup. Phaeochromocytoma can lead to cardiac involvement in the form of left ventricular dysfunction, or catecholamine-induced myocarditis.

Background Cancer is the second most common cause of death globally after cardiovascular disease, and cancer patients are at an increased risk of CV death. This recognition has led to publication of cardio‐oncological guidelines and to the widespread adoption of dedicated cardio‐oncology services in many institutes. However, it is unclear whether there has been a change in the incidence of CV death in cancer patients. Methods and Results Using Centers for Disease Control and Prevention Wide‐Ranging, Online Data for Epidemiologic Research (CDC WONDER) Multiple Cause of Death dataset, we determined national trends in age‐standardised mortality rates attributed to cardiovascular diseases in patients with and without cancer, from 1999 to 2019, stratified by cancer type, age, gender, race, and place of residence (state and urbanisation status). Among more than 17.8 million cardiovascular deaths in the United States, 13.6% were patients with a concomitant cancer diagnosis. During the study period, among patients with cancer, the age‐adjusted mortality rate dropped by 52% (vs 38% in patients with no cancer). In cancer patients, age‐adjusted mortality rate dropped more significantly among patients with gastrointestinal, breast, and prostate malignancy than among patients with haematological malignancy (59%‐63% vs. 41%). Similar reduction was observed in both genders (53%‐54%), but more prominent reduction was observed in older patients and in those living in metro areas. Conclusions Our findings emphasise the role of multidisciplinary management of cancer patients. Widespread adoption of cardio oncology services have the potential to impact the inherent risk of increased CV mortality in both cancer patients and survivors.

Myocarditis is an uncommon association of Crohn's disease. It has been reported to occur independently of inflammatory bowel disease activity. The case history is presented of a young woman admitted to hospital with acute small bowel obstruction as a presentation of active Crohn's disease which was further complicated by fulminant myocarditis leading to cardiogenic shock. This could have proved fatal if not recognised and managed appropriately. Myocarditis is rare, but it can be a life-threatening association of inflammatory bowel disease which needs early recognition and prompt treatment.

Myocarditis is an uncommon association of Crohn disease. It has been reported to occur independently of inflammatory bowel disease activity. The case history is presented of a young woman admitted to hospital with acute small bowel obstruction as a presentation of active Crohn disease, which was further complicated by fulminant myocarditis leading to cardiogenic shock. This could have proved fatal if not recognised and managed appropriately. Myocarditis is rare, but it can be a life-threatening association of inflammatory bowel disease that needs early recognition and prompt treatment.

No abstract