Acute viral myopericarditis presenting as a transient effusive-constrictive pericarditis caused by coinfection with coxsackieviruses A4 and B3.
Acute myopericarditis is usually caused by viral infections, and the most common cause of viral myopericarditis is coxsackieviruses. Diagnosis of myopericarditis is made based on clinical manifestations of myocardial (such as myocardial dysfunction and elevated serum cardiac enzyme levels) and pericardial (such as inflammatory pericardial effusion) involvement. Although endomyocardial biopsy is the gold standard for the confirmation of viral infection, serologic tests can be helpful. Conservative management is the mainstay of treatment in acute myopericarditis. We report here a case of a 24-year-old man with acute myopericarditis who presented with transient effusive-constrictive pericarditis. Echocardiography showed transient pericardial effusion with constrictive physiology and global regional wall motion abnormalities of the left ventricle. The patient also had an elevated serum troponin I level. A computed tomogram of the chest showed pericardial and pleural effusion, which resolved after 2 weeks of supportive treatment. Serologic testing revealed coxsackievirus A4 and B3 coinfection. The patient received conservative medical treatment, including nonsteroidal anti-inflammatory drugs, and he recovered completely with no complications.
Division of Cardiology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Wang-Soo
WS
Lee
Kwang Je
KJ
Lee
Jee Eun
JE
Kwon
Min Seok
MS
Oh
Jeong Eun
JE
Kim
Eun Jung
EJ
Cho
Chee Jeong
CJ
Kim
D000208:Acute Disease; D060085:Coinfection; D003384:Coxsackievirus Infections / Q000150:complications / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D029821:Enterovirus A, Human / Q000302:isolation & purification*; D029822:Enterovirus B, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D010490:Pericardial Effusion / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D010494:Pericarditis, Constrictive / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D010996:Pleural Effusion / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult