ArticleInternational medical case reports journal2026
Post-Diphtheritic Myocarditis with Right Ventricular Thrombus: A Rare Cardiac Complication.
Article in International medical case reports journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Myocarditis is a serious consequence of diphtheria; however, the occurrence of a subsequent right ventricular (RV) thrombus is exceedingly rare. We provide an uncommon case of post-diphtheritic myocarditis complicated by a right ventricular thrombus and secondary pneumonia, emphasizing its effective multi-modal therapy and subsequent recovery. Case Presentation: A 19-year-old female arrived at our emergency department with acute dyspnea and chest pain two weeks after a 3-day hospitalization for pharyngeal diphtheria at Galkacyo Regional Hospital. Laboratory analyses revealed increased Troponin I (2615 ng/L), CK (511 U/L), and severely high NT-proBNP (33,349.0 pg/mL). Chest radiography verified the presence of simultaneous right lower lobe pneumonia. Electrocardiography revealed low-voltage QRS complexes, whereas echocardiogram indicated worldwide hypokinesia (LVEF 40-45%) and a movable hypoechoic mass at the right ventricular apex, strongly suggesting the presence of a right ventricular thrombus. Management and Outcome: The patient was admitted to a designated ICU bed and commenced on broad-spectrum antibiotics, guideline-recommended heart failure pharmacotherapy (metoprolol, furosemide, empagliflozin), and therapeutic anticoagulation with subcutaneous enoxaparin. She was released on a two-month regimen of oral anticoagulation. Five-month serial follow-up demonstrated total clearance of the right ventricular thrombus, a fully normalized ejection fraction, and complete remission of all symptoms. Conclusion: This case demonstrates that patients continue to be susceptible to toxin-induced myocarditis and intracardiac thrombosis even in the convalescent phase. It highlights Virchow's Triad in post-diphtheritic conditions and illustrates that timely heart failure treatment, along with a systematic 2-month anticoagulation protocol, can result in remarkable myocardial healing and total thrombus clearance.
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