Intramyocardial haemorrhage: a rare sequela of acute myopericarditis

INTRODUCTION Acute myopericarditis is an inflammatory disease of myocardium and pericardium. The disease has variable presentation ranging from mildly symptomatic cases to severe disease manifested by cardiomyopathy with associated risk of sudden cardiac death. However, the association with intramyocardial hemorrhage (IMH) has not been previously described. CASE REPORT We describe an IMH detected by cardiac magnetic resonance imaging, in a patient with classical ‘de novo’ myopericarditis. To the best of the authors’ knowledge, this has not been previously described in patients without associated haematological or connective tissue disorders. CONCLUSION The adverse prognostic signal of IMH in acute myocardial infarction may also be reflected by IMH in acute myopericarditis and lead to adverse ventricular remodeling. The pathophysiology of IMH in myopericarditis is unknown and warrants further exploration.