Case Report
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World J Cardiol. Jul 26, 2013; 5(7): 265-269
Published online Jul 26, 2013. doi: 10.4330/wjc.v5.i7.265
Non-coronary myocardial infarction in myasthenia gravis: Case report and review of the literature
Panagiotis Zis, Stavros Dimopoulos, Vasiliki Markaki, Antonios Tavernarakis, Serafim Nanas
Panagiotis Zis, Antonios Tavernarakis, Department of Neurology, Evangelismos Hospital, 10676 Athens, Greece
Stavros Dimopoulos, Vasiliki Markaki, Serafim Nanas, 1st Critical Care Medicine Department, Evangelismos Hospital, National Kapodistrian University of Athens, 10676 Athens, Greece
Author contributions: Zis P and Dimopoulos S have contributed to the clinical management of case, have made the appropriate literature review and have written the paper; all other others have contributed to the clinical management of case and have reviewed the paper.
Correspondence to: Stavros Dimopoulos, MD, PhD, 1st Critical Care Medicine Department, Evangelismos Hospital, National Kapodistrian University of Athens, Ipsilantou 45-47, 10676 Athens, Greece. stdimop@gmail.com
Telephone: +30-69-73956974 Fax: +30-210-2107242785
Received: April 17, 2013
Revised: June 10, 2013
Accepted: July 4, 2013
Published online: July 26, 2013
Processing time: 106 Days and 17.2 Hours
Abstract

Cardiovascular adverse events in patients with myasthenia gravis (MG) are rare, but the early recognition of such events is crucial. We describe a case of a non-coronary myocardial infarction (MI) during the initial treatment period with pyridostigmine bromide in a female patient with MG. Clinicians should be cautious about the appearance of potential MI in patients with MG. A baseline electrocardiogram is advocated, when the early recognition of the MI clinical signs and the laboratory findings (myocardial markers) are vital to the immediate and appropriate management of this medical emergency, as well as to prevent future cardiovascular events. In this case report possible causes of myocardial adverse events in the context of MG, which may occur during the ongoing treatment and the clinical course of the disease, are discussed.

Keywords: Myasthenia gravis; Myocardial infarction; Pyridostigmine

Core tip: Cardiovascular adverse events in patients with myasthenia gravis (MG) are rare, but the early recognition of such events is crucial. We describe a case of a non-coronary myocardial infarction during the initial treatment period with pyridostigmine bromide in a female patient with MG. In this case report possible causes of myocardial adverse events in the context of MG, which may occur during the ongoing treatment and the clinical course of the disease, are discussed.