From Hepatitis to Heartbreak: A Rare Encounter with Myocarditis

Background: Symptoms of viral myocarditis include cardiogenic shock and deadly arrhythmia. In certain people, the condition can progress to chronic myocarditis and dilated cardiomyopathy. We describe a case of Hepatitis A virus-induced hepatitis with viral myocarditis. Case presentation: A 42-year-old woman with anorexia, exhaustion, and fever was brought to our hospital. Computed CT revealed diffuse liver edema and an interior heterogeneous image, and the initial investigation revealed raised liver enzyme levels and creatine phosphokinase. Lab investigations revealed positive anti-HAV IgG by ELISA (0.68), consistent with recent Hepatitis A infection. Liver function tests showed marked hepatocellular injury with total bilirubin of 9.7 mg/dL, conjugated bilirubin of 2.4 mg/dL, AST 3849 U/L, and ALT 2024 U/L. Echocardiography revealed a dilated, spherical ventricle with decreased systolic function and pericardial effusion, while electrocardiography revealed broad ST-segment elevation. Chest X-ray was unremarkable. Abdominal ultrasound showed hepatomegaly, mild ascites, an oedematous gallbladder with sludge, and gamma-Gandy bodies in the spleen. Conclusion: We reported a rare instance of Hepatitis A virus-induced myocarditis and hepatitis. Since hepatitis, pancreatitis, nephritis, and encephalitis can all coexist with acute myocarditis, it is essential to identify the presence of additional infectious disorders in order to treat the patient appropriately. Keywords: Myocarditis, Hepatitis, Case report