Coronary vasospasm as the underlying cause for chest pain in patients with PVB19 myocarditis

Yılmaz, Ali; Mahrholdt, Heiko; Athanasiadis, Anastasios; Vogelsberg, Holger; Meinhardt, Gabriel; Voehringer, Matthias; Kispert, Eva-Maria; Deluigi, Christina; Baccouche, Hannibal; Spodarev, Evgeny; Klingel, Karin; Kandolf, Reinhard; Sechtem, Udo

doi:10.1136/hrt.2007.131383

Cited by 158 publications

(102 citation statements)

References 38 publications

(39 reference statements)

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“…They also demonstrated that PVB19 infection tended to manifest like myocardial infarction, while HHV6 infection was likely to present with heart failure [11]. This notion was supported by a study with biopsy-proven myocarditis, where coronary artery vasospasm was more frequent in PVB19 myocarditis as compared with HHV6 myocarditis [9], and by reports that PVB19 preferentially invades vascular endothelial cells preferably, while HHV6 targets immune cells [12][13][14].…”

Section: Discussionsupporting

confidence: 67%

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Phantom Ischemia Mimicking ST Segment Elevation Myocardial Infarction in Fulminant Myocarditis

Kim

Lee

et al. 2012

Ewha Med J

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A 30-year-old man visited the emergency room for chest pain, dyspnea and fever. Despite increased serum cardiac enzymes, ST segment elevation and inferior wall akinesis in electrocardiography and echocardiography, no atherosclerosis was evident in the coronary angiography. However, radionuclide myocardial perfusion image at day 2 showed a persistent perfusion defect in the left ventricular (LV) inferior wall. At day 3, prominent myocardial edema and severe LV systolic dysfunction developed with signs of heart failure. In this case, fulminant myocarditis seemed to originate from the right coronary artery territory and simulated a ST segment elevation myocardial infarction without coronary artery obstruction. The pathogenesis of the localized perfusion defect was unlcear. (Ewha Med J 2012;35(2):129-134)

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Section: Discussionsupporting

confidence: 67%

“…However, there has been uncertainty concerning the mechanism of coronary artery vasospasm associated with myocarditis and there are opinions that coronary vasospasm depends on the property of the invading virus [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Phantom Ischemia Mimicking ST Segment Elevation Myocardial Infarction in Fulminant Myocarditis

Kim

Lee

et al. 2012

Ewha Med J

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“…Coronary spasm has been observed with this presentation in adults. 70 Parvovirus B19 has been found in the myocardium of such patients, as well as adenovirus and Epstein-Barr virus. 71 In a study of 4436 patients presenting to a pediatric emergency department with chest pain, 24 had a confirmed cardiac origin, of whom 4 were diagnosed with myocarditis.…”

Section: Chest Pain/myocardial Infarctionmentioning

confidence: 99%

Diagnosis and Treatment of Myocarditis in Children in the Current Era

2014

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“…Especially myocarditis caused by Parvovirus B19, which affects endothelial cells, has been associated with coronary vasospasm [2] . While coronary vascular smooth muscle cell dysfunction leading to Prinzmetal angina is an important differential diagnosis as well as coronary spasm on atherosclerotic coronary disease, myocarditis is an important but probably less frequent diagnosis to consider.…”

Section: Discussionmentioning

confidence: 99%

Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction

Kumar

Bagur

Béliveau

et al. 2014

WJC

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A 24-year-old healthy man consulted to our center because of typical on-and-off chest-pain and an electrocardiogram showing ST-segment elevation in inferior leads. An urgent coronary angiography showed angiographically normal coronary arteries. Cardiovascular magnetic resonance imaging confirmed acute myocarditis. Although acute myocarditis triggering coronary spasm is an uncommon association, it is important to recognize it, particularly for the management for those patients presenting with ST-segment elevation and suspect myocardial infarction and angiographically normal coronary arteries. The present report highlights the role of cardiovascular magnetic resonance imaging to identify acute myocarditis as the underlying cause. Key words: Myocarditis; Acute coronary syndrome; Coronary spasm; Myocardial infarction Core tip: The present report highlights the role of cardiovascular magnetic resonance imaging to identify acute myocarditis as the underlying cause of coronary spasm presenting with ST-segment elevation myocardial infarction in a young healthy man.Kumar A, Bagur R, Béliveau P, Potvin JM, Levesque P, Fillion N, Tremblay B, Larose É, Gaudreault V. Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction.

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Coronary vasospasm as the underlying cause for chest pain in patients with PVB19 myocarditis

Abstract: Coronary vasospasm is one of the main reasons for atypical chest pain in patients with clinical signs of myocarditis and biopsy-proven PVB19 myocarditis in the absence of significant CAD.

Cited by 158 publications

References 38 publications

Phantom Ischemia Mimicking ST Segment Elevation Myocardial Infarction in Fulminant Myocarditis

Phantom Ischemia Mimicking ST Segment Elevation Myocardial Infarction in Fulminant Myocarditis

Diagnosis and Treatment of Myocarditis in Children in the Current Era

Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction

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