[Ventricular extrasystole as manifestation of viral myocarditis and myopericarditis in young patients].
OBJECTIVE
To investigate relationship between frequent and complicated ventricular extrasystole (VE) in young patients and previous viral myocarditis (VM); to study VE long-term prognosis.


METHODS
We examined 75 patients with mild and moderate myocarditis which developed after acute respiratory infections and other viral diseases (Coxsackie infection was serologically confirmed in 49%; flu, paraflu and adenoviral infection--in 8%). Acute myocarditis was diagnosed basing on the data of ECG, activity of cardiospecific enzymes and isoenzymes, x-ray, echocardiography, Holter ECG monitoring, exercise tests. The patients were followed up from 3 to 26 years (mean 14.6 years).


RESULTS
Bigeminal polymorphic extrasystoles and bigemia sites persisted for the whole periods of observation. They could disappear at resting ECG but were registered at 24-h ECG monitoring in all the cases. Echocardiography detected fibrous alterations of the pericardium with its thickening in 89% cases. Exercise tolerance test at the end of the study recorded normal physical performance in 89.3% patients. This suggests a favorable disease outcome. Low physical performance, moderate dilation of the left ventricle and ejection fraction lowering to 48% requiring medication were observed only in 4 patients who were capable to work.


CONCLUSIONS
Frequent and complicated VE after viral myocarditis were present at resting ECG for many years in 42.3% patients. Holter 24-h ECG monitoring registered VE in all the examinees. 89% patients had fibrous lesions of the pericardium showing that viral myocarditis in most cases runs as myopericarditis, in some cases being subclinical.
Stulova
M A
MA
Konstantinova
E V
EV
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D003384:Coxsackievirus Infections / Q000150:complications* / Q000503:physiopathology / Q000821:virology; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D029822:Enterovirus B, Human / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000150:complications* / Q000503:physiopathology / Q000821:virology; D010493:Pericarditis / Q000150:complications* / Q000503:physiopathology / Q000821:virology; D011379:Prognosis; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology
D000914:Antibodies, Viral