Acute myocarditis. Serologic diagnosis, clinical findings and follow-up.
In a prospective study, 57 patients with a preliminary diagnosis of myocarditis were investigated. Twenty-four patients were considered to have an acute myocarditis, 14 had a suspected myocarditis, while in 19 patients myocarditis was excluded. Episodes of frequent supraventricular and/or ventricular extrasystoles during hospital stay were seen in 8/24 cases (33%) with myocarditis and in 1/19 cases (5%) without myocarditis. On follow-up 1 month later, no supraventricular extrasystoles were observed in either group. Echocardiographic signs consistent with left ventricular insufficiency were noted in 7/24 cases (29%) with myocarditis, in 1/14 cases (7%) with suspected myocarditis and in no case without myocarditis. With a "routine" serologic test battery covering influenza viruses A and B, adenovirus, Coxsackie virus group B, ECHO viruses, Chlamydia psittaci, Mycoplasma pneumoniae and hemolytic streptococci group A, a possible etiology could be documented in 9/24 cases (38%) with myocarditis and in 4/19 cases (21%) without myocarditis. Enterovirus-specific IgM was detected with solid-phase reverse immunosorbent test (SPRIST) in 12/23 (48%) cases with myocarditis and in 3/16 cases (19%) without myocarditis. In SPRIST-IgM-positive cases, IgM antibodies were detected in 15/20 (75%) of the sera taken on admission. The overall serological results indicated a recent infection in 16/24 cases (67%) with myocarditis and in 5/19 cases (26%) without myocarditis (p less than 0.05).
Vikerfors
T
T
Department of Infectious Diseases, Orebro Medical Center Hospital, Sweden.
Stjerna
A
A
Olcén
P
P
Malmcrona
R
R
Magnius
L
L
D000208:Acute Disease; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D001145:Arrhythmias, Cardiac / Q000175:diagnosis; D004452:Echocardiography; D004770:Enterovirus / Q000276:immunology / Q000302:isolation & purification; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D007163:Immunosorbent Techniques; D008297:Male; D009205:Myocarditis / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D011446:Prospective Studies
D000914:Antibodies, Viral; D007075:Immunoglobulin M