Page 108 - BH-2-4

Brain & Heart

CASE REPORT
Acute coronary syndrome or cardiac

involvement due to leptospirosis: A case report

Ayşe Sağmak Tartar * , Mehmet Ali Aşan 1 , Murat Harman 2 , and
1
Türkkan Öztürk Kaygusuz 1
1 Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Firat University,
Elazig, Turkey
2 Department of Cardiology, Faculty of Medicine, Firat University, Elazig, Turkey

Abstract

Leptospirosis is a globally prevalent zoonotic infection. Cardiac involvement in
leptospirosis, including myocarditis, can be easily missed due to non-specific
symptoms and concurrent multiorgan dysfunction. A 46-year-old male presented
to the emergency department with weakness, fever, palpitations, and widespread
joint and muscle pain. His temperature was 40°C, and his blood pressure dropped
to 50/30 mm Hg. The patient, with elevated high-sensitivity troponin levels in
laboratory findings, was referred to the cardiology department. Anti-ischemic
treatment was started for a preliminary diagnosis of acute coronary syndrome. The
leptospirosis polymerase chain reaction (PCR) test in serum was positive, whereas
the urine Leptospira PCR test was negative. The patient presented with septic shock
and elevated cardiac biomarkers and was re-evaluated based on electrocardiogram
and echocardiogram findings. Considering these clinical and laboratory results,
*Corresponding author: acute coronary syndrome was ruled out, and myocardial involvement due to
Ayşe Sağmak Tartar leptospirosis was considered. This case highlights the importance of recognizing
(dr.ayse01@gmail.com) cardiac involvement in leptospirosis.
Citation: Tartar AS, Aşan MA,
Harman M, Kaygusuz TO. Acute
coronary syndrome or cardiac Keywords: Leptospirosis; Zoonotic infection; Myocarditis
involvement due to leptospirosis:
A case report. Brain & Heart.
2024;2(4):3496.
doi: 10.36922/bh.3496
Received: April 24, 2024 1. Background
Accepted: July 29, 2024 Leptospirosis is a globally prevalent zoonotic infection. Severe leptospirosis is
characterized by multiorgan dysfunction involving the liver, kidneys, lungs, and heart.
1,2
Published Online: October 8, 2024 Cardiac involvement in leptospirosis, including myocarditis, is sometimes overlooked
Copyright: © 2024 Author(s). owing to its non-specific symptoms and the presence of multiorgan dysfunction.
This is an Open-Access article Accurate diagnosis of cardiac involvement in leptospirosis requires a high level of clinical
distributed under the terms of the
Creative Commons Attribution suspicion, as fatal outcomes may often be linked to myocarditis.
License, permitting distribution,
3
and reproduction in any medium, Mathew et al. examined cardiac findings and biomarker levels in 113 severe patients
provided the original work is with leptospirosis requiring intensive care and compared them with 31 patients with
properly cited. sepsis. They found similar electrocardiographic (EKG) abnormalities and myocardial
Publisher’s Note: AccScience dysfunction levels (51% – 55%) in both groups. However, patients with leptospirosis
Publishing remains neutral with exhibited higher troponin-T levels (61.0% vs. 40.0%, p = 0.057). Elevations in the
regard to jurisdictional claims in
published maps and institutional ST-segment and troponin levels were identified as independent predictors of reduced
affiliations. left ventricular (LV) ejection fraction in leptospirosis.

Volume 2 Issue 4 (2024) 1 doi: 10.36922/bh.3496