Heart failure from gouty myocarditis: a case report

Myocarditis is an important cause of heart failure, and successful treatment depends on identifying the underlying cause and mechanism. Infectious and autoimmune diseases are the most common causes, although myocarditis can also be caused by endocrine disorders, such as pheochromocytoma; infiltrative disorders, such as amyloidosis; and metabolic disorders. Gout is a metabolic disorder characterized by increased uric acid in the blood and the deposition of amorphous urate crystals that cause a vigorous inflammatory reaction in the joints, kidneys, and soft tissues. Urate crystals have been found in coronary vessels and cardiac valves but, to our knowledge, not in the myocardium.