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Case Reports
. 2018 Sep-Oct:51:111-113.
doi: 10.1016/j.clinimag.2018.01.014. Epub 2018 Feb 6.

Necrotizing infection of the heart

David H Ballard  1 , George Patton Pennington 2nd  2 , George P Pennington  3 , Joe Johnson  3 , Sanjeev Bhalla  4 , Constantine Raptis  4
Affiliations
Case Reports

Necrotizing infection of the heart

David H Ballard et al. Clin Imaging. 2018 Sep-Oct.

Abstract

A case of necrotizing infection of the heart is presented. A 70-year-old woman presented with vague chest and abdominal pain. CT of the abdomen and pelvis was initially obtained, which demonstrated gas in the myocardium of the left ventricle. Subsequent chest CT, endoscopy, and abdominal surgical exploration did not reveal perforated viscus or diaphragm compromise. At median sternotomy, the inferior wall of the heart was found to be necrotic. Culture of the excised tissue grew E. coli. The patient expired shortly after surgical exploration.

Keywords: CT chest; Cardiac infection; Computed tomography; Necrotizing fasciitis; Necrotizing infection; Pneumomyocardium.

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Conflict of interest statement

DISCLOSURES: None – all authors claim no conflicts of interest or disclosures.

Figures

Figure 1.
Figure 1.
Initial portable chest radiograph demonstrates a subtle oval lucency (arrow) projecting at the midline inferior aspect of the cardiac silhouette.
Figure 2.
Figure 2.
Computed tomography (CT) of the chest without intravenous contrast (contrast was withheld in all CT examinations due to impaired renal function)(A-C). Axial (A, B) CT images along with coronal (C) reconstructions confirm that the pneumomyocardium in confined to the inferior wall (A-C, thick arrows). A small to moderate pericardial effusion is demonstrated (A-C, thin solid arrows). Small bilateral pleural effusions (A, B), coronary artery calcifications (A-C), and calcifications of the thoracic aorta (A-C) are also noted.
See this image and copyright information in PMC

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