Abstract
We report a case of Aspergillus myocarditis presenting as myocardial infarction in a patient with acute myeloblastic leukemia. A 49-year-old-man was intubated and mechanically ventilated in the ICU as a result of invasive Aspergillus pneumonia and acute respiratory insufficiency following chemotherapy in combination with corticosteroid. His electrocardiogram on the 12th ICU day revealed sudden complete atrioventricular block, ST-segment elevation, and then cardiac arrest. Although resuscitative efforts with catecholamine and temporary pacemaker could maintain heart rate and blood pressure for a while, the patient got aggravated and passed away on the next day. Postpartum examination revealed multiple organ failure caused by Aspergillus infection and myocardial necrosis along with abscess formation mainly in the epimyocardium. These findings indicate that anomalous electrocardiogram in a patient with Aspergillosis may be a symptom of Aspergillus myocarditis. You should remember that cardiac Aspergillosis does not have any clinically characteristic feature, and therefore diagnosing Aspergillus myocarditis is quite difficult until autopsy and precarious treatment often fails a patient.
