Pathological substratum for clinical features of fatal myocarditis.
Heart autopsies in six cases of fatal myocarditis were examined clinicopathologically. Included were 2 cases in the acute stage, 1 in the subacute stage and 3 in the chronic stage. As to microscopical dating changes, at the acute stage, numerous inflammatory cells were found in the edematous interstitium after 2 days from onset and degeneration, i.e., destruction of myocardial cells without fibrous replacement, was also noted after 11 days. At the subacute stage, irregular patchy and slightly loose fibrosis with inflammatory cells and vascularization was found after 50 days. At the chronic stage, loose fibrosis with inflammatory cells and tight fibrosis without the cells, that is, active and healed myocarditis co-existed. All cases showed heart failure of varying degrees, and also showed, respectively, complete AV block and ventricular fibrillation at the acute stage, and complete AV block and sustained ventricular tachycardia at the chronic stage. In myocarditis, which often was difficult to diagnose clinically, the pathological findings corresponded well to the clinical features retrospectively.
Department of Second Internal Medicine, Fukuoka University School of Medicine, Japan.
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Fukuda
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Arakawa
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000473:pathology; D002648:Child; D002908:Chronic Disease; D005260:Female; D006327:Heart Block / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000401:mortality / Q000473:pathology*; D013610:Tachycardia / Q000150:complications