Transient Left Ventricular “Hypertrophy” in a Woman with Meningoencephalitis

Abstract

We report the echocardiographic findings in a 27-year-old woman with viral meningoencephalitis and a positive test for cardiac troponin. Initially, the basal parts of the left ventricle were severely hypokinetic, whereas contraction in the mid-ventricle and apex was normal. A second echocardiogram obtained 19 days after the development of pulmonary edema showed a generalized, severe myocardial thickening, the left ventricular ejection fraction being normal. Three months after the initial examination the "hypertrophy" had disappeared. The serial echocardiograms along with a positive cardiac troponin led to the diagnosis of myocarditis, which can very rarely present with the echocardiographic picture of severe left ventricular thickening.

Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis – a CMR study

“…The ventricular wall thickening as well as the edema resolved in the convalescent phase of the disease. These results are also supported by several echocardiographic reports describing a transient LV hypertrophy during inflammation[ 14 , 27 ]. Following the conclusions of Hiramitsu et al, we do think that the observed decrease in LV mass in our study is comparable to their data and most likely reflects the regression of myocardial edema although we are not able to verify this finding with histological data.…”

Myocarditis

“…Even if wall thickening might be a subtle phenomenon, it can be detected by echocardiography [5,[20][21][22][23][24][25]. Even if wall thickening might be a subtle phenomenon, it can be detected by echocardiography [5,[20][21][22][23][24][25].…”