Table 1.
Myocarditis/myopericarditis in AML patients.
| Age/sex | Presentation | Cardiac evaluation | Leukemic evaluation | Treatment | Author |
|---|---|---|---|---|---|
| 37/F | Acute exertional chest pain with radiation to arms. | Negative coronary artery angiography. TTE: EF of 50–55% with hypokinetic right ventricle. Cardiac MRI: EF of 33% with signal changes consistent with myocarditis. | AML “confirmed on bone marrow biopsy.” | Myopericarditis: colchicine and NSAIDs. | Snavely et al. [7] |
| ECG with ST elevations in leads I, aVL, V1, and V2 and PR elevation in lead AVR. Troponin elevated at 1.6 ng/mL. | AML treatment not stated. | ||||
| CBC showed WBC of 13.7 k/µL with 28% blasts, Hgb of 10.0 g/dL, and Plts 145 k/µL. | |||||
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| 48/M | Acute substernal chest pain. Febrile (103.4°F). | Negative coronary artery angiography with an ejection fraction of 40–45%. There was mild hypokinesis in the midinferior and mid-anterolateral walls and no pericardial effusions. TTE revealed the same findings. | Bone marrow biopsy: hypercellular marrow with diffuse mononuclear infiltrates with flow cytometry consistent with AML. FISH analysis was positive for t(6; 9) (p23; q34). | Myopericarditis: colchicine 0.6 mg BID; ibuprofen 600 mg TID | Agrawal et al. [8] |
| ECG with ST segment elevation in leads I, II, aVL, and V5 with PR elevation and ST depression in aVR. Troponin-I was 14.8 ng/mL. CBC revealed hemoglobin of 10.8 g/dL, white cell count of 13,000/µL, 56% blasts, absolute neutrophil count of 1,430/µL, and platelet count of 83 × 103/µL. | AML: 7 d cytarabine and 3 d idarubicin followed by salvage therapy with HIDAC and midostaurin. | ||||
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| 62/M | Acute chest pain. ECG with ST elevation in inferior leads. Troponin of 1.5 µg/L. | TTE: normal biventricular function with inferolateral hypokinesia. Angiography: normal coronary arteries. | Bone marrow biopsy: 47% blasts suggestive for AML. | Myocarditis: anti-inflammatory therapy. | De Lazzari et al. [9] |
| Cardiac MRI: cardiac dysfunction with areas of myocardial edema and late enhancement. | AML: fludarabine, steroids, and cytarabine. | ||||
AML: acute myeloid leukemia; CBC: complete blood count; ECG: electrocardiogram; EF: ejection fraction; FISH: fluorescence in situ hybridization; Hgb: hemoglobin; HIDAC: high-dose cytarabine; Plts: platelets; TTE: transthoracic echocardiogram; WBC: white blood cells.