Stress-induced cardiomyopathy can occur during myasthenia gravis crisis, particularly with malignant thymoma, but myocardial function typically recovers with treatment.
Alerts clinicians to possible stress cardiomyopathy in MG crisis; hypothesis-generating for cardiac monitoring in thymoma cases.
OBJECTIVES: Myocardial pathology is rarely associated with myasthenia gravis (MG). We describe a case of newly diagnosed MG with decompensated heart failure [stress-induced cardiomyopathy (SICM)] that occurred during the crisis phase. METHODS: Case report and review of literature. RESULTS: A 42-year-old woman underwent chemotherapy followed by a transsternal resection of a malignant epithelioid thymoma invading the pericardium. A month after surgical resection, she developed progressive oropharyngeal symptoms with respiratory distress requiring tracheal intubation. Cardiac evaluation on the day of admission showed a normal ejection fraction, which rapidly decreased to 15% on the second hospital day and recovered to 45% after 1 week. Review of the literature revealed 4 myasthenic patients who developed SICM in the crisis phase; all improved with treatment. CONCLUSIONS: SICM may occur in MG crisis, especially in the presence of malignant thymoma. All previous cases including our patient had improved myocardial function and clinical outcomes.
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Thanaviratananich et al. (2014) studied this question.
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