The role of echocardiography in acute viral myocarditis

Matshela, Mamotabo R

doi:10.5830/cvja-2018-069

Cited by 11 publications

(8 citation statements)

References 28 publications

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“…Griffin found the viral spectrum of VMC in myocardial specimens was mostly HAdV, followed by HEV, as well as CMV and HSV [11]. Finally, VMC caused by multiple viruses is also more common than before [6,12]. The results of our study showed that among the patients with VMC, a co-infection of HHV-6/7 and Parvovirus B-19 was found in the one patient.…”

Section: Discussionsupporting

confidence: 48%

Diagnosis of Viral Myocarditis in Children with Clinical Suspicion of Myocarditis by Multiplex Real-time PCR in Birjand Vali-Asr Hospital, East of Iran

Salehi

Yousefi

2019

Preprint

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Background Viral myocarditis (VMC) is one of the common heart diseases to endanger human health in different age groups, especially children. The aim of this study was diagnosis of viral myocarditis in children with clinical suspicion of myocarditis by multiplex Real-time PCR in Birjand Vali-Asr hospital.Methods This cross-sectional research conducted on 19 patients with clinical suspicion of myocarditis who had evidence of microbial infections in recent weeks. Routine electrocardiogram and dynamic ECG examinations, auxiliary laboratory testing and echocardiographic evaluation were performed. Multiplex Real-time PCR by Neuro kit was used for detection of viral agents in blood or pericardial fluid samples.Results The results indicated that 4 out of 19 (21.05%) patients with myocarditis were found to be virus positive. The spectrum of viral agents was included HHV-6/7, Parvovirus B-19, EBV, VZV and Adenoviruses. A co-infection of HHV-6/7 and Parvovirus B-19 was found in the one patient. ECG findings such as sinus tachycardia with ST-T changes, premature ventricular contraction and complete heart block were found in VMC patients. The predominant echocardiographic features in the patients with VMC were a low ejection fraction, mitral regurgitation and severe pericardial effusion with hypotension. AST and LDH abnormal increase were found in the some patient.Conclusions Our findings highlight the importance of identification of VMC in children with clinical suspicion of myocarditis. The present study emphasizes the importance of PCR-based assays for detection of viral agents in myocarditis patients with symptoms of virus infection.

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Section: Discussionsupporting

confidence: 48%

Diagnosis of Viral Myocarditis in Children with Clinical Suspicion of Myocarditis by Multiplex Real-time PCR in Birjand Vali-Asr Hospital, East of Iran

Salehi

Yousefi

2019

Preprint

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“…Echocardiography is an essential part of myocarditis diagnostics that helps assess LV function and eliminate other causes of heart failure. 58,59 Previous studies have also illustrated that in Covid-19 patients with myocardial injury, echocardiography often reveals normal to mildly reduced LVEF along with mild RV failure. 60,61 Despite the fact that non-specific findings are seen on echocardiograms in myocarditis, a comprehensive review of the results may help to indicate a diagnosis, initial management, and to evaluate prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…The bulk of patients in this review exhibited reduced LVEF and pleural effusion on echocardiogram. Echocardiography is an essential part of myocarditis diagnostics that helps assess LV function and eliminate other causes of heart failure 58,59 . Previous studies have also illustrated that in Covid‐19 patients with myocardial injury, echocardiography often reveals normal to mildly reduced LVEF along with mild RV failure 60,61 .…”

Section: Discussionmentioning

confidence: 99%

Myocarditis associated with Covid‐19 disease: A systematic review of published case reports and case series

Rathore¹,

Rojas

Sondhi

et al. 2021

Int J Clin Pract

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Background: Covid-19 is an extremely contagious illness caused by the severe acute respiratory syndrome (SARS-CoV-2) virus. The cardiac involvement in such a public health emergency disease has not been well studied and a conflicting evidence exists on this issue. Objective: This systematic review article aimed to compile and illustrate clinical characteristics, diagnostic findings, management, and outcomes manifesting in myocarditis linked with Covid-19. Methods: A literature search was accomplished for published eligible articles with MEDLINE/PubMed and Embase databases. All eligible case reports and case series were included from around the world without any language restrictions. For this review, inclusion criteria were laboratory-confirmed SARS-CoV-2 infection cases reporting a diagnosis of acute myocarditis. Results: Data from 41 studies describing myocarditis in 42 Covid-19 patients was obtained. The median age of these patients was 43.4 years, with 71.4% of them being men. Fever was the most prevalent presenting symptoms seen in 57% of patients. Hypertension was the most pervasive comorbidity accompanying these patients. Cardiac biomarkers troponin and brain natriuretic peptide (BNP) were raised in almost 90% and 87% of patients, respectively. Electrocardiogram findings were nonspecific and included ST-segment and T-wave changes. Echocardiogram commonly showed left ventricular systolic dysfunction with increased heart size. Cardiac magnetic resonance imaging (CMRI) exhibited myocardial edema and injury. The most prevalent histopathological feature appreciated was diffuse lymphocytic inflammatory infiltrates. Antivirals and corticosteroids were the most frequently used medications. About 38% of patients also needed vasopressor assistance. Out of 42 patients, 67% recovered, and eight died. Conclusion:Because of the risk of a sudden worsening of patients conditions and myocarditis association with considerable mortality and morbidity, a knowledge of this cardiac complication of Covid-19 disease is crucial for healthcare professionals.

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“…As mentioned above, ECG has a key role in the assessment of severity. Of note, UCG, whose diagnostic criteria have been suggested and adopted for myocarditis patients, may also be used to distinguish FM from myocarditis (23,24). In the near future, the role of UCG in myocarditis patients we be further studied.…”

Section: Discussionmentioning

confidence: 99%

Role of electrocardiograms in assessment of severity and analysis of the characteristics of ST elevation in acute myocarditis: A two‑centre study

Chen

et al. 2020

Exp Ther Med

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Acute myocarditis is a severe disease with a high mortality rate and various dynamic changes visible on electrocardiograms (ECGs). The purpose of the present study was to investigate ECG findings of patients with acute myocarditis, ECG findings associated with fulminant myocarditis (FM) and the characteristics of ST elevation on admission. A retrospective analysis of 1,814 ECGs of 274 consecutive patients with acute myocarditis aged ≥13 years, who were hospitalized in two centres between August 2007 and November 2019, was performed. A total of 251 patients with myocarditis (91.6%) presented with ECG abnormalities. The most common ECG findings were T-wave inversion and ST elevation. Univariate logistic regression analysis demonstrated that 12 ECG findings were associated with FM. Multivariate regression analysis revealed that the independent predictive factors for FM included ventricular tachycardia, high-degree atrioventricular block, sinus tachycardia, low voltage and QRS duration of ≥120 msec (all P<0.05). A total of 112 cases displayed ST elevation at admission. Of these, ST elevation without T-wave inversion (n=87) was associated with a shorter duration of cardiac symptoms (1.5 vs. 3.1 days; P<0.001) compared with ST elevation with T-wave inversion (n=25). Of the aforementioned 87 patients, 71 (81.6%) presented with T-wave inversion at the hospital. The median time from the onset of cardiac symptoms to T-wave inversion was 4.0 days. In conclusion, patients with acute myocarditis exhibited various dynamic changes on ECG. Thus, ECGs should be widely used for the assessment of severity and the characteristics of ST elevation on admission.

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The role of echocardiography in acute viral myocarditis

Cited by 11 publications

References 28 publications

Diagnosis of Viral Myocarditis in Children with Clinical Suspicion of Myocarditis by Multiplex Real-time PCR in Birjand Vali-Asr Hospital, East of Iran

Diagnosis of Viral Myocarditis in Children with Clinical Suspicion of Myocarditis by Multiplex Real-time PCR in Birjand Vali-Asr Hospital, East of Iran

Myocarditis associated with Covid‐19 disease: A systematic review of published case reports and case series

Role of electrocardiograms in assessment of severity and analysis of the characteristics of ST elevation in acute myocarditis: A two‑centre study

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