Abstract

Presented here is a case of a 29 year old patient with Whipple's disease. The first symptoms had appeared seven years before diagnosis. At the beginning, the patient complained of arthralgia. Following a symptomless period he underwent a myocardial infarction complicated by cardiogenic shock, pulmonary edema and ventricular fibrillation. Due to therapy, the patients state improved, but during the follow-up period related to antibiotic treatment, we observed an increase in the akinetic and hypokinetic area of the myocardium as well as in the pressure of the pulmonary artery. Following one year, diarrhea, loss of body mass and malabsorption symptoms appeared. We observed an increase in the hypokinetic area of the myocardium and pulmonary pressure. During the diagnostic process, we performed endoscopy of the upper part of the digestive tract. Based on the endoscopy, as well as on light and electron microscope examinations of the duodenal mucosa, we diagnosed Whipple's disease. Following penicillin treatment, the patients state improved and we observed withdrawal or reduction of previously seen ecg and echocardiographic changes. Based on the above mentioned, we concluded that the cardiologic symptoms of our patient, were a result of a myocardial inflammatory process during the course of Whipple's disease.

Keywords: hemorrhagia, Myocardial Infarction, Whipple