ABC | Volume 115, Nº1, Suplement, July 2020

Case Report Graça-Santos et al. Myocardial involvement in Sweet Syndrome Arq Bras Cardiol 2020; 115(1Suppl.1):6-9 1. Cohen PR. Sweet’s syndrome - a comprehensive review of an acute febrile neutrophilic dermatosis. Orphanet J Rare Dis. 2007 jul 26;2:34. 2. Villarreal-Villarreal CD, Ocampo-Candiani J, Villarreal-Martínez A. Sweet Syndrome:AReviewandUpdate.ActasDermosifiliogr. 2015;107(5):369-78. 3. Cohen PR, Kurzrock R. Sweet’s syndrome revisited: a review of disease concepts. Int J Dermatol. 2003;42(10):761-78. 4. Von denDriesch P. Sweet’s syndrome (acute febrile neutrophilic dermatosis). J Am Acad Dermatol. 1994;31(4):535-56. 5. DorenkampM,WeikertU,MeyerR,SchwimbeckPL,MorguetAJ.Heartfailure in acute febrile neutrophilic dermatosis. Lancet. 2003;362(9393):1374. 6. Yu WY, Manrriquez E, Bhutani T, Chaganti RK, Ruben BS, Schwartz BS, et al. Sweet heart: A case of pregnancy-associated acute febrile neutrophilic dermatosis with myopericarditis. JAAD Case Rep. 2014;1(1):12-4. 7. Montalescot G, Sechtem U, Achenbach S, Sechtem U, Andreotti F, Arden C, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on themanagement of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34(38):2949-3003. 8. Caforio AL, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB, et al. Currentstateofknowledgeonaetiology,diagnosis,management,andtherapyof myocarditis:apositionstatementoftheEuropeanSocietyofCardiologyWorking GrouponMyocardialandPericardialDiseases. EurHeartJ .2013;34(33):2636-48. References pattern of significant CAD), 13 and the prompt response to corticosteroids raised the likelihood of AM. Due to clinical stability and the well‑known limitations of EMB, a CMR was later performed and suggested this diagnosis according to the Lake‑Louise criteria. 8,12 In fact, CMR has emerged as a useful non‑invasive diagnostic tool and there is growing evidence that novel techniques, such as T1 and T2 mapping, may improve its diagnostic accuracy for myocarditis and help monitor disease evolution. 8,14,15 Additionally, GLPSS normalized three months after treatment, while the patient remained asymptomatic. Final messages The case we present emphasizes the importance of acknowledging SS as a rare yet plausible cause of cardiovascular disease, and one that should be early recognized in order to start adequate treatment. In this case, the diagnosis of AM was highly suggested by the combination of non-invasive imaging modalities after CAD exclusion. To our best knowledge, this was the first time CMR was used to assess myocardial involvement in a patient with SS and also the first to report the use of 2D-STE for evolution Figure 4 – Cardiovascular magnetic resonance imaging. (A) T1-weighted image demonstrating patchy subepicardial late gadolinium enhancement (red arrows) in the basal portion of the inferior wall; (B) T2-weighted image presenting focal regions of increased signal intensity (yellow arrow) suggestive of slight oedema in the inferolateral wall. monitoring. Both cutaneous and cardiovascular manifestations completely regressed after corticosteroid treatment. Author contributions Conception and design of the research and Data acquisition: Santos LG, Kieselova K; Analysis and interpretation of the data: Santos LG, Kieselova K, Sá FM, Guardado J; Writing of the manuscript: Santos LG, Sá FM, Morais JA; Critical revision of the manuscript for intellectual content: Guardado J, Morais JA. Potential Conflict of Interest The authors report no conflict of interest concerning the materials and methods used in this study or the findings specified in this paper. Sources of Funding There was no external funding source for this study. Study Association This study is not associated with any thesis or dissertation. 8