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Acute viral myocarditis.

Dennert R, Crijns HJ, Heymans S - Eur. Heart J. (2008)

Bottom Line: This leads to the need for new diagnostic approaches, which resulted in the emergence of new molecular tests and a more detailed immunohistochemical analysis of endomyocardial biopsies.Recent findings using these new diagnostic tests resulted in increased interest in inflammatory cardiomyopathies and a better understanding of its pathophysiology, the recognition in overlap of virus-mediated damage, inflammation, and autoimmune dysregulation.Novel results also pointed towards a broader spectrum of viral genomes responsible for acute myocarditis, indicating a shift of enterovirus and adenovirus to parvovirus B19 and human herpes virus 6.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, CARIM, University Hospital Maastricht, The Netherlands.

ABSTRACT
Acute myocarditis is one of the most challenging diagnosis in cardiology. At present, no diagnostic gold standard is generally accepted, due to the insensitivity of traditional diagnostic tests. This leads to the need for new diagnostic approaches, which resulted in the emergence of new molecular tests and a more detailed immunohistochemical analysis of endomyocardial biopsies. Recent findings using these new diagnostic tests resulted in increased interest in inflammatory cardiomyopathies and a better understanding of its pathophysiology, the recognition in overlap of virus-mediated damage, inflammation, and autoimmune dysregulation. Novel results also pointed towards a broader spectrum of viral genomes responsible for acute myocarditis, indicating a shift of enterovirus and adenovirus to parvovirus B19 and human herpes virus 6. The present review proposes a general diagnostic approach, focuses on the viral aetiology and associated autoimmune processes, and reviews treatment options for patients with acute viral myocarditis.

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Electrocardiogram showing PQ-segment depression and diffusely elevated ST-T-segments at presentation (A) and evolution after 1 day (B).
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EHN296F4: Electrocardiogram showing PQ-segment depression and diffusely elevated ST-T-segments at presentation (A) and evolution after 1 day (B).

Mentions: Patients with acute myocarditis frequently have abnormal ECGs ranging from conduction delays to ECGs mimicking acute MI or acute pericarditis.37,62 Its sensitivity is estimated at 47%, but its specificity remains unknown.63 Acute myocarditis may also result in ‘idiopathic’ atrial or ventricular arrhythmias, PQ-segment depression, and diffusely elevated ST-T-segments (Figure 4) which evolve in ST-T-segment depression.64


Acute viral myocarditis.

Dennert R, Crijns HJ, Heymans S - Eur. Heart J. (2008)

Electrocardiogram showing PQ-segment depression and diffusely elevated ST-T-segments at presentation (A) and evolution after 1 day (B).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2519249&req=5

EHN296F4: Electrocardiogram showing PQ-segment depression and diffusely elevated ST-T-segments at presentation (A) and evolution after 1 day (B).
Mentions: Patients with acute myocarditis frequently have abnormal ECGs ranging from conduction delays to ECGs mimicking acute MI or acute pericarditis.37,62 Its sensitivity is estimated at 47%, but its specificity remains unknown.63 Acute myocarditis may also result in ‘idiopathic’ atrial or ventricular arrhythmias, PQ-segment depression, and diffusely elevated ST-T-segments (Figure 4) which evolve in ST-T-segment depression.64

Bottom Line: This leads to the need for new diagnostic approaches, which resulted in the emergence of new molecular tests and a more detailed immunohistochemical analysis of endomyocardial biopsies.Recent findings using these new diagnostic tests resulted in increased interest in inflammatory cardiomyopathies and a better understanding of its pathophysiology, the recognition in overlap of virus-mediated damage, inflammation, and autoimmune dysregulation.Novel results also pointed towards a broader spectrum of viral genomes responsible for acute myocarditis, indicating a shift of enterovirus and adenovirus to parvovirus B19 and human herpes virus 6.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, CARIM, University Hospital Maastricht, The Netherlands.

ABSTRACT
Acute myocarditis is one of the most challenging diagnosis in cardiology. At present, no diagnostic gold standard is generally accepted, due to the insensitivity of traditional diagnostic tests. This leads to the need for new diagnostic approaches, which resulted in the emergence of new molecular tests and a more detailed immunohistochemical analysis of endomyocardial biopsies. Recent findings using these new diagnostic tests resulted in increased interest in inflammatory cardiomyopathies and a better understanding of its pathophysiology, the recognition in overlap of virus-mediated damage, inflammation, and autoimmune dysregulation. Novel results also pointed towards a broader spectrum of viral genomes responsible for acute myocarditis, indicating a shift of enterovirus and adenovirus to parvovirus B19 and human herpes virus 6. The present review proposes a general diagnostic approach, focuses on the viral aetiology and associated autoimmune processes, and reviews treatment options for patients with acute viral myocarditis.

Show MeSH
Related in: MedlinePlus