myocarditis compared with the background population was 8.3 for Crohn’s disease and 2.6 for ulcerative colitis.13 In the past, sepsis was the most common cause of death in patients with Crohn’s disease, but GI cancer has become the leading cause of mortality. Moreover, pulmonary embolism, amyloidosis, steroid side effects, short bowel syndrome, protein losing enteropathy, and extraintestinal manifestations, such as ischemic heart diseases, cerebral vascular diseases, and conges- tive heart failure have increased in importance.1,14 In summary, we experienced a case of acute myocarditis as the initial complicated presentation of Crohn’s disease and re- port this case with a review of the literature. Since the cardiac manifestations of Crohn’s disease can be fatal, further work should explore the pathophysiology, natural history, and prog- nosis of these interactions. CONFLICTS OF INTEREST No potential conflict of interest relevant to this article was reported. REFERENCES 1. Sands BE, Siegel CA. Crohn’s disease. In: Sleisenger MH, Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s gastro- intestinal and liver disease: pathophysiology, diagnosis, manage- ment. Volume 2. 9th ed. Philadelphia: Saunders, 2010:1941-1973. 2. Jackson JF, Sitaraman SV. Pericarditis as the presenting sign of Crohn’s disease. Inflamm Bowel Dis 2005;11:81-82. 3. Hyttinen L, Kaipiainen-Seppänen O, Halinen M. Recurrent myo- pericarditis in association with Crohn’s disease. J Intern Med 2003;253:386-388. Oh IS, et al: Acute Myocarditis in Crohn’s Disease 515 4. Greenstein AJ, Janowitz HD, Sachar DB. The extra-intestinal com- plications of Crohn’s disease and ulcerative colitis: a study of 700 patients. Medicine (Baltimore) 1976;55:401-412. 5. Weiss N, Rademacher A, Zoller WG, Schlöndorff D. Myocarditis and subcutaneous granulomas in a patient with Crohn’s disease of the colon. Am J Med 1995;99:434-436. 6. Iizuka B, Yamagishi N, Honma N, Hayashi N. Cardio vascu- lar disease associated with ulcerative colitis. Nihon Rinsho 1999;57:2540-2545. 7. Kupferschmidt H, Langenegger T, Krähenbühl S. Pericarditis in chronic inflammatory bowel disease: underlying disease or side ef- fects of therapy? Clinical problem solving. Schweiz Med Wochen- schr 1996;126:2184-2190. 8. Gujral N, Friedenberg F, Friedenberg J, Gabriel G, Kotler M, Levine G. Pleuropericarditis related to the use of mesalamine. Dig Dis Sci 1996;41:624-626. 9. Cooper LT Jr. Myocarditis. N Engl J Med 2009;360:1526-1538. 10. Savoia MC, Oxman MN. Myocarditis and pericarditis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infec- tious diseases. 6th ed. Edinburgh: Elsevier Churchill Livingstone, 2004:1053-1058. 11. Mavrouli MD, Spanakis N, Levidiotou S, et al. Serologic prevalence of coxsackievirus group B in Greece. Viral Immunol 2007;20:11- 18. 12. Kwon CI, Hong SP, Choi YJ, et al. A case of acute dilated cardio- myopathy caused by coxsackie virus B in a patient with Crohn’s disease. Korean J Gastroenterol 1999;34:125-130. 13. Sorensen HT, Fonager KM. Myocarditis and inflammatory bowel disease. A 16-year Danish nationwide cohort study. Dan Med Bull 1997;44:442-444. 14. Andrews HA, Lewis P, Allan RN. Mortality in Crohn’s disease: a clinical analysis. Q J Med 1989;71:399-405.