Clinical presentation and long-term follow-up of perimyocarditis.
BACKGROUND
The natural history of perimyocarditis (PMY) is not yet completely known. We aimed to analyse the clinical laboratory data of PMY at diagnosis and during follow-up, in order to assess the natural history and prognostic stratification of the disease (including different aetiology).


METHODS
We enrolled 62 consecutive patients (men 79%, aged 38 ± 18 years) with PMY (84% idiopathic, 8% autoimmune, 8% infective) from August 2002 to July 2010. The diagnosis has been made according to clinical and laboratory data (significant increase of troponin I in all patients). After at least 1 year (mean follow-up: 1635 ± 298 days), 59 patients (95%) had available data.


RESULTS
Chest pain was present in 59 patients (95%), flu-like syndrome in 36 (58%) and pericardial rubs in 15 (24%). None of the patients showed heart failure at presentation. At admission, eight patients (13%) presented mild-moderate left ventricular systolic dysfunction, 13 (22%) showed wall motion abnormalities, and 10 (17%) showed mild pericardial effusion. At 1 year no patients died, developed heart failure or showed abnormal echocardiogram. NSAIDs were the first choice therapy in 61 (98%) patients with clinical resolution in 58 (95%) of them. Seven patients (12%) experienced intermittent recurrences without development of constrictive pericarditis or heart failure.


CONCLUSIONS
This study underlines the benign mid- to long-term outcome of PMY regardless of clinical laboratory characteristics at presentation, different aetiology and possibility of relapses; minimizing the role of endomyocardial biopsy in these specific patients.
Cardiovascular Department, Ospedali Riuniti and University of Trieste, Trieste, Italy. elam4@libero.it
Alessandra
A
Buiatti
Marco
M
Merlo
Bruno
B
Pinamonti
Marzia
M
De Biasio
Rossana
R
Bussani
Gianfranco
G
Sinagra
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010493:Pericarditis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D011379:Prognosis; D012008:Recurrence; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal