Lip and Skin Lesions with the Appearance of Blebs/Papules
A 38-year-old healthy woman developed lip and skin lesions with the appearance of blebs/papules 2 months ago.
She had swelling of her legs, progressive dyspnea on exertion, fatigue for 2 weeks, and paroxysmal nocturnal dyspnea for 4 days.
QUESTION 1. The findings in Videos 20-1 to 20-4 are most consistent with:
A. Ischemic cardiomyopathy
B. Cardiomyopathy due to valvular disease
C. Acute perimyocarditis
D. Peripartum cardiomyopathy
E. Idiopathic cardiomyopathy
View Answer
ANSWER 1: C. The prodrome with skin and mucosal lesions are consistent with a viral myocarditis. The most common viruses associated with myocarditis are Coxsackievirus, influenza virus, adenovirus, echovirus, cytomegalovirus, and HIV.
The depressed myocardial function may be due to direct cytotoxicity via receptor-mediated entry of the virus into cardiac myocytes as well as an adverse autoimmune response to the infectious agent.
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