Delayed Diagnosis of Myocarditis After Blunt Abdominal Trauma: A Rare Case Report
Case Report
DOI:
https://doi.org/10.55175/cdk.v53i06.2015Keywords:
Abdominal trauma, cardiogenic shock, case report, impaired heart function, myocarditisAbstract
Introduction: Myocarditis is an inflammation of the myocardium that can lead to impaired heart function and sudden death. Most cases are caused by viral infections and are very rarely reported as a post-traumatic complication. Case: A 54-year-old male developed abdominal pain and vomiting after blunt abdominal trauma. The patient was initially diagnosed with colonic rupture and underwent exploratory laparotomy. Despite initial improvement, the patient experienced hemodynamic deterioration. Electrocardiography, cardiac biomarkers,
and echocardiography evaluation revealed myocarditis with decreased ejection fraction. Despite supportive and pharmacological therapy, the patient fell into cardiogenic shock and passed away. Discussion: This case demonstrates that the diagnosis of myocarditis can be
significantly delayed in patients with atypical presentations and no obvious cardiac symptoms. Abdominal trauma accompanied by systemic infection, such as colonic rupture, may potentially cause secondary myocardial inflammation. Clinicians need to consider the possibility of myocarditis in patients with postoperative hemodynamic instability, even without a history of cardiac disease. Conclusion: This report highlights the urgency of improving diagnostic awareness of myocarditis and access to support facilities.
Downloads
References
Brociek E, Tyminska A, Giordani AS, Caforio ALP, Wojnicz R, Grabowski M, et al. Myocarditis: etiology, pathogenesis, and their implications in clinical practice. Biology (Basel). 2023;12(6):1–23. doi: 10.3390/biology12060874.
Lampejo T, Durkin SM, Bhatt N, Guttmann O. Acute myocarditis: aetiology, diagnosis and management. Clin Med J R Coll Physicians London. 2021;21(5):E505–10. doi: 10.7861/clinmed.2021-0121.
Shams P, Kiel J. Acute myocarditis [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2026 May 28]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441847/.
Ikegami Y, Tsukada Y, Abe M, Abe Y, Tase C. Delayed shock after minor blunt trauma due to myocarditis caused by occult giant pheochromocytoma. J Trauma. 2009;67(3):E65–8. doi: 10.1097/TA.0b013e31802b9587.
Lasica R, Djukanovic L, Savic L, Krljanac G, Zdravkovic M, Ristic M, et al. Update on myocarditis: from etiology and clinical picture to modern diagnostics and methods of treatment. Diagnostics 2023;13(19):3073. doi: 10.3390/diagnostics13193073.
Golpour A, Patriki D, Hanson PJ, McManus B, Heidecker B. Epidemiological impact of myocarditis. J Clin Med. 2021;10(4):1–15. doi: 10.3390/jcm10040603.
Fayadh R. Clinical presentation. In: Diagnosis and treatment of myocarditis [Internet]. Rijeka (HR): InTechOpen; 2013 [cited 2026 May 28]. Available from: http://www.intechopen.com/books/diagnosis-and-treatment-of-myocarditis/dtm-clinical-presentation.
Martens P, Cooper LT, Tang WHW. Diagnostic approach for suspected acute myocarditis: considerations for standardization and broadening clinical spectrum. J Am Heart Assoc. 2023;12(17):14. doi: 10.1161/JAHA.123.031454.
Ammirati E, Frigerio M, Adler ED, Basso C, Birnie DH, Brambatti M, et al. Management of acute myocarditis and chronic inflammatory cardiomyopathy. Circ Hear Fail. 2020;13(11):e007405. doi: 10.1161/CIRCHEARTFAILURE.120.007405.
Andriono P, Achmadsyah A. MRI as diagnostic modality of myocarditis in patients with unexplained chest pain. Cermin Dunia Kedokt.2025;52(1):27–31. https://doi.org/10.55175/cdk.v52i1.1129.
Liguori C, Farina D, Vaccher F, Ferrandino G, Bellini D, Carbone I. Myocarditis: imaging up to date. Radiol Med. 2020;125(11):1124–34. https://doi.org/10.1007/s11547-020-01279-8.
Hasanah DY, Zulkarnain E, Arifianto H, Prameswari HS, Suciadi LP, Probo P, et al. Indonesian Journal of Cardiology 2023 Indonesian guidelines for heart failure treatment: Working Group on Heart Failure and Cardiometabolic Diseases, Indonesian Heart Association. Indones J Cardiol Indones J Cardiol. 2024;45(Ii):68–103. https://doi.org/10.30701/ijc.1671.
Ferone E, Segev A, Tempo E, Gentile P, Elsanhoury A, Baggio C, et al. Current treatment and immunomodulation strategies in acute myocarditis. J Cardiovasc Pharmacol. 2024;83(5):364–76. doi: 10.1097/FJC.0000000000001542.
Golino M, Harding D, Del Buono MG, Fanti S, Mohiddin S, Toldo S, et al. Innate and adaptive immunity in acute myocarditis. Int J Cardiol. 2024;404:131901. doi: 10.1016/j.ijcard.2024.131901.
Prasanna G, Nair D, Shah A. 176 Off-target: soccer ball trauma to the chest masks a case of myocarditis. Am J Med Sci. 2025;369:S112–3. doi: 10.1016/S0002-9629(25)00184-3.
Dunsire MF, Field J, Valentine S. Delayed diagnosis of cardiac tamponade following isolated blunt abdominal trauma. Br J Anaesth. 2001;87(2):309–12. doi: 10.1093/bja/87.2.309.
Childs L, Gupta S. Salmonella enteritidis induced myocarditis in a 16-year-old girl. BMJ Case Rep. 2012;2012:bcr2012007628. doi: https://doi.org/10.1136/bcr-2012-007628.
Suehiro W, Nishio R, Noiri J ichi, Takeshige R, Konishi H, Matsuzoe H, et al. Acute myocarditis secondary to Campylobacter jejuni enteritis: a case report. J Cardiol Cases. 2023;28(5):185–8. doi: 10.1016/j.jccase.2023.06.008.
Marshall JC. Intra-abdominal infections. Microbes Infect. 2004;6(11):1015–25. doi: 10.1016/j.micinf.2004.05.017.
Sartelli M. A focus on intra-abdominal infections. World J Emerg Surg. 2010;5(1):9. https://doi.org/10.1186/1749-7922-5-9.
Kyaw MT, Myint T, Lwin TZ. Acute myocarditis in a young male after gastroenteritis: a case report and literature review. Clin Case Reports. 2022;10(12):e06699. doi: 10.1002/ccr3.6699.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Astrid Carolinn Valleriana Kaiba, Putu Aditya Darmawan Kuntadi, Nabil Athoillah
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
