title: Focal parvovirus B19 myocarditis in a patient with Brugada syndrome.
abstract: The Brugada syndrome is characterized by a distinct ECG pattern consisting of ST segment elevation in the right precordial leads and right bundle branch block, a propensity for life-threatening arrhythmias, and an apparently structurally normal heart. The authors describe the case of a patient with an aborted sudden cardiac death and the typical ECG signs of Brugada syndrome. Nevertheless, magnetic resonance imaging displayed signal enhancement in the left ventricular myocardium. Additionally, histologic examination, in-situ hybridization, and PCR revealed evidence of a locally restricted inflammation due to parvovirus B19. Brugada syndrome is regarded as a primary electrical disease due to dysfunction of distinctive ion channels, but focal myocarditis may serve as a trigger for ventricular arrhythmias in this patient. Further morphologic studies will be helpful to establish the possible role of structural changes in the pathophysiology of this syndrome.
authors.affiliation: Medizinische Klinik und Poliklinik, Innere Medizin III, Universitätskliniken des Saarlandes, D-66421 Homburg/Saar, Germany. buob@med-in.uni-sb.de
authors.forename: Axel
authors.initials: A
authors.lastname: Buob
authors.forename: Stephanos
authors.initials: S
authors.lastname: Siaplaouras
authors.forename: Ingrid
authors.initials: I
authors.lastname: Janzen
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schwaab
authors.forename: Bernd
authors.initials: B
authors.lastname: Hammer
authors.forename: Günther
authors.initials: G
authors.lastname: Schneider
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kandolf
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
authors.forename: Jens
authors.initials: J
authors.lastname: Jung
mesh_terms: D000328:Adult; D002037:Bundle-Branch Block / Q000150:complications / Q000175:diagnosis* / Q000821:virology*; D017023:Coronary Angiography; D016757:Death, Sudden, Cardiac / Q000209:etiology; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis* / Q000821:virology*; D010322:Parvoviridae Infections; D016732:Parvovirus B19, Human