Acute Myocarditis and Left Ventricular Hypertrophy

Echocardiographic abnormalities of myocarditis are polymorphous and nonspecific. The presence of increased ventricular wall thickness, typically transient, is an infrequent finding in myocarditis that can correspond to an improvement in the clinical status of the patient and the ejection fraction. We report the case of a patient with acute myocarditis and the echocardiographic abnormalities observed during the course of his myocarditis: transient left ventricular hypertrophy associated with improvement of the left ventricular function.     

Acute Lymphocyte Myocarditis Associated with Influenza Vaccination

An elderly patient was admitted to our hospital for acute heart failure soon after receiving influenza vaccination. On admission, chest radiography revealed pulmonary edema. An electrocardiogram showed poor R progression, and echocardiography showed diffuse hypokinesis and myocardial edema. The serum troponin level was elevated. A histopathological evaluation indicated active myocarditis with lymphocyte-predominant infiltrates. A drug-induced lymphocyte stimulation test (DLST) was positive. The patient rapidly recovered from heart failure after treatment with conventional heart failure drugs, such as intravenous diuretics and vasodilators. These experimental data and the clinical course suggest that influenza vaccination was responsible for heart failure due to acute lymphocyte myocarditis.     

Acute Myocarditis with Severe Fever and Thrombocytopenia Syndrome

A 67-year-old man, hospitalized with fever and pancytopenia, experienced cardiogenic shock on the 3rd day of hospitalization. He complained of chest pain and exhibited cardiac dysfunction, upregulated serum troponin levels, and an ST elevation on electrocardiogram. Severe fever with thrombocytopenia syndrome (SFTS) was suspected based on the symptom course after a tick bite and was definitively diagnosed using the serum polymerase chain reaction (PCR) test. An endomyocardial biopsy performed in the convalescent phase revealed a sign of myocardial inflammation with increases in CD3- and CD68-positive cells. We herein report the first case of acute myocarditis complicated with SFTS.     

参附注射液治疗急性病毒性心肌炎的疗效观察

目的探讨参附注射液在治疗急性病毒性心肌炎的疗效.方法对120例确诊的病人随机分为治疗组和对照组.对照组采用传统内科治疗方法,予以休息、营养心肌及对症处理;治疗组在对照组的基础上,加用参附注射液.2周后观察症状、心电图及心肌损伤标志物的变化.结果治疗组对症状、心律失常、ST-T改变及心肌损伤标志物的改善程度优于对照组.结论参附注射液结合西医治疗对急性病毒性心肌炎具有更好的疗效.     

Acute Myocarditis in a Patient Following mRNA-1273 SARS-CoV-2 Vaccination

We herein report a case of acute myocarditis possibly related to the second dose of an mRNA-coronavirus disease 2019 vaccine in a 45-year-old woman with no remarkable medical history. She had a fever for one week following the second dose of the mRNA-1273 severe acute respiratory syndrome coronavirus 2 vaccine. One week later, she presented with chest pain and electrocardiogram changes. Her serum troponin levels were elevated upon admission. Echocardiography showed segmental wall motion abnormalities of the apex, apical portion of the anterior and inferior walls. The findings of cardiac magnetic resonance imaging were consistent with acute myocarditis.     

Delayed Recovery of Diastolic Function in Patients with Suspected Acute Myocarditis as Assessed with Doppler Echocardiography

Pulsed-wave Doppler echocardiography was performed repeatedly in two women (24 and 23 years old) who had clinically suspected acute myocarditis. Systolic function recovered earlier than diastolic function in both cases. Although left ventricular diastolic dysfunction has been demonstrated in lymphocytic myocarditis, this difference in the rates of systolic and diastolic function recovery after acute myocarditis has not been previously described. The slower recovery of the diastolic function might be related to the slower resolution of the infiltrated myocardium. We also discuss the contribution of echocardiography to the difference in the rates of cardiac function recovery after acute myocarditis.     

Myocarditis and Methyldopa

ABSTRACT. Six patients with myocarditis and hepatitis, attributed to an allergic reaction to methyldopa, are described. Granulomatous pneumonitis was also found in four of them.     

Electrocardiographic Predictors of Morbidity and Mortality in Patients With Acute Myocarditis: The Importance of QRS-T Angle

Background

Acute myocarditis carries a variable prognosis. We evaluated the morbidity and mortality rates in patients with acute myocarditis and admission electrocardiographic predictors of outcome.

Acute Late-Stage Myocarditis in the Crab-Eating Macaque Model of Hemorrhagic Smallpox

Hemorrhagic smallpox, caused by variola virus (VARV), was a rare but nearly 100% lethal human disease manifestation. Hemorrhagic smallpox is frequently characterized by secondary bacterial infection, coagulopathy, and myocardial and subendocardial hemorrhages. Previous experiments have demonstrated that intravenous (IV) cowpox virus (CPXV) exposure of macaques mimics human hemorrhagic smallpox. The goal of this experiment was to further understand the onset, nature, and severity of cardiac pathology and how it may contribute to disease. The findings support an acute late-stage myocarditis with lymphohistiocytic infiltrates in the CPXV model of hemorrhagic smallpox.     

Fatal Influenza A Myocarditis with Isolation of Virus from the Myocardium

A previously healthy 27-year-old woman developed an acute cardiac failure one week after onset of influenza-like respiratory infection, and died on her fourth day in hospital. Intravital differential diagnosis included myocardial infarction because of ECG changes and massive elevation of myocardial enzymes. Autopsy revealed severe myocarditis and intact coronary arteries. At microscopic examination the myocardium was heavily infiltrated with lymphocytes, and there was a marked myo-cytolysis. Influenza A virus was isolated from the myocardial tissue. An immunological mechanism of myocardial damage is suggested.     

Fatal Mumps Myocarditis

Abstract A case of fatal mumps myocarditis in a 38-year-old male is reported. The disease started with orchitis, and severe cardiac symptoms developed within 1 1/2 month. The patient died 5 months later from congestive heart failure. The possible interrelation between late stages of viral myocarditis and dilated (congestive) cardiomyopathy is emphasized.     

从细胞介导免疫探讨养阴清心口服液治疗急性病毒性心肌炎的作用及临床研究

目的：从细胞介导免疫探讨养阴清心口服液治疗急性病毒性心肌炎的作用及临床研究。方法：将急性病毒性心肌炎病人随机分为治疗组50例服养阴清心口服液，对照组15例服维生素C和肌苷。从临床症状、心电图、T细胞亚群、NK细胞和IgM等方面观察该药的作用机制。结果：在总疗效、症状疗效、心电图疗效方面，治疗组均明显优于对照组。CD4／CD8的比值，治疗组较治疗前有明显下降。CD4值治疗前后无明显差异。CD8值较治疗前明显上升。治疗组治疗后NK值较治疗前增加，而对照组在治疗后NK值无明显变化。治疗组治疗后IgM转阴率较高。结论：临床研究证明，养阴清心口服液在临床疗效和心电图改善及免疫指标－T细胞亚群（CD4／CD8）降低、NK细胞值升高及IgM转阴等方面，通过发挥免疫调节功能而起到治疗病毒性心肌炎的作用，为当前治疗急性病毒性心肌炎的较佳选择。     

免疫治疗病毒性心肌炎进展

病毒性心肌炎与机体免疫反应密切相关。免疫治疗心肌炎包括免疫抑制治疗、免疫球蛋白、细胞因子、中药治疗、以及对病例选择后进行针对性运用某一免疫制剂治疗和药物间取长补短综合治疗 ,后两种方法相对成功     

Course of Cardiac Magnetic Resonance Imaging Findings in Acute Myocarditis after COVID-19 mRNA Vaccination

Myocarditis is being increasingly reported as a rare complication of coronavirus disease 2019 (COVID-19) mRNA vaccines. We herein report a case of myocarditis following COVID-19 mRNA vaccination in a man. Cardiac magnetic resonance imaging (CMRI) revealed an area of high signal intensity on short T1 inversion recovery (STIR) and late gadolinium enhancement (LGE), which are characteristic of myocarditis. Follow-up CMRI performed six months later revealed improvement in the myocardial edema and LGE findings. CMRI is a useful non-invasive imaging modality for making an initial diagnosis as well as for follow-up in cases of myocarditis after COVID-19 mRNA vaccination.     

Myocarditis in the pediatric population: A review

Myocarditis has a variable clinical presentation and there is still debate regarding accurate diagnostic criteria. Adding to the controversy surrounding this diagnosis, there is no clear consensus for the treatment or ongoing follow‐up of patients with myocarditis. All of this makes the diagnosis and management of myocarditis a particular challenge in the pediatric population. Furthermore, the literature with respect to this topic is dynamic and ever‐changing. In this review article, we aim to review and summarize the common clinical presentations of myocarditis, along with the latest recommendations for diagnostic criteria, treatment, and follow‐up of patients with myocarditis.     

Myeloid-Derived Suppressor Cells Restrain Natural Killer Cell Activity in Acute Coxsackievirus B3-Induced Myocarditis

Murine models of coxsackievirus B3 (CVB3)-induced myocarditis well represent the different outcomes of this inflammatory heart disease. Previously, we found that CVB3-infected A.BY/SnJ mice, susceptible for severe acute and chronic myocarditis, have lower natural killer (NK) cell levels than C57BL/6 mice, with mild acute myocarditis. There is evidence that myeloid-derived suppressor cells (MDSC) may inhibit NK cells, influencing the course of myocarditis. To investigate the MDSC/NK interrelationship in acute myocarditis, we used CVB3-infected A.BY/SnJ mice. Compared to non-infected mice, we found increased cell numbers of MDSC in the spleen and heart of CVB3-infected A.BY/SnJ mice. In parallel, S100A8 and S100A9 were increased in the heart, spleen, and especially in splenic MDSC cells compared to non-infected mice. In vitro experiments provided evidence that MDSC disrupt cytotoxic NK cell function upon co-culturing with MDSC. MDSC-specific depletion by an anti-Ly6G antibody led to a significant reduction in the virus load and injury in hearts of infected animals. The decreased cardiac damage in MDSC-depleted mice was associated with fewer Mac3⁺ macrophages and CD3⁺ T lymphocytes and a reduced cardiac expression of S100A8, S100A9, IL-1β, IL-6, and TNF-α. In conclusion, impairment of functional NK cells by MDSC promotes the development of chronic CVB3 myocarditis in A.BY/SnJ mice.     

柯萨奇-腺病毒受体与病毒性心肌炎

柯萨奇 腺病毒受体是一种普通的存在于心肌细胞表面的病毒受体 ,作为柯萨奇病毒和腺病毒的共同受体 ,在它们感染心肌细胞的过程中起着关键性的作用。