1/16. Doppler aortic flow pattern in the recovering heart treated by cardiac extracorporeal membrane oxygenation International Society for artificial organs.A 39-year-old man was admitted to our hospital because of chest pain and was diagnosed with severe heart failure due to viral myocarditis. Intraaortic balloon pumping (IABP) and cardiac extracorporeal membrane oxygenation (ECMO) were employed. Using Doppler echocardiography, we evaluated the descending aortic blood flow pattern. When cardiac ECMO was initiated from the right femoral artery, a strong backflow of blood generated by the pump was observed in the abdominal aorta because the forward flow from the native heart was weak. Two days later, the blood flow was reversed from the thoracic to abdominal aorta; the natural flow was strengthened because the native heart had improved. The observation of this phenomenon is helpful for determining the recovery of cardiac function under cardiac ECMO support.- - - - - - - - - - ranking = 1keywords = myocarditis (Clic here for more details about this article) |
2/16. Th1/Th2 balance alteration in the clinical course of a patient with acute viral myocarditis.cytokines have an important role in the pathogenesis and pathophysiology of myocarditis. In this study, subsets of peripheral helper T lymphocytes (Th) in a patient with acute viral myocarditis were analyzed by 3-color flow cytometry. During the clinical course of myocarditis, the Th1/Th2 ratio of peripheral lymphocytes changed. Th1 was dominant in the acute inflammatory phase during which levels of creatine kinase (CK) increased (day 6), then Th2 levels overtook those of Th1 in the recovery phase during which levels of CK decreased (day 13 and 20). At the time of discharge (day 35), Th1 and Th2 had normalized. Thus, it was speculated that the induction of lymphocytic myocarditis was associated with Th1 dominant status, and recovery was related to Th2 polarity. Th subset imbalances may play an important role in the pathogenesis of acute viral myocarditis and these analyses may be useful for understanding the disease activity of myocarditis.- - - - - - - - - - ranking = 10keywords = myocarditis (Clic here for more details about this article) |
3/16. Endomyocardial biopsy findings in cases with pericarditis or perimyocarditis.In order to determine the presence or absence of myocarditis in cases with viral or idiopathic pericarditis, a study was conducted as one of our series on endomyocardial biopsy. There were two groups of patients, pericarditis cases (n = 8), and patients with perimyocarditis (n = 6). In the former group, it was confirmed that cardiac sarcoplasmic enzymes were not released during the acute stage of the disease. In the latter, there was positive evidence of the enzyme release. Also, employing our method of categorizing the possibility of myocarditis at the histopathological level, we found that the category 'highly suggestive' of myocarditis was absent in all eight cases with pericarditis. However, in cases with perimyocarditis, this category was assigned in four out of six cases (67%), indicating a high incidence. The category, 'slightly suggestive', was seen in three cases of the former (38%) and two cases of the latter group (33%). It is concluded that in patients with pericarditis, the release of cardiac sarcoplasmic enzyme is an important diagnostic element in the diagnosis of perimyocarditis even if the clinical features reveal a predominance of pericarditis. In patients with perimyocarditis, progression to residual cardiac disease, such as conduction disturbance or congestive heart failure, is likely.- - - - - - - - - - ranking = 11keywords = myocarditis (Clic here for more details about this article) |
4/16. Acute viral myocarditis. A death associated with anaesthesia.The death of a 35-year-old woman in the immediate postoperative period as a result of undiagnosed acute viral myocarditis is described. The presentation, diagnosis and course of the disease is discussed. It is recommended that wider use to be made of routine electrocardiographs as a screening test.- - - - - - - - - - ranking = 5keywords = myocarditis (Clic here for more details about this article) |
5/16. Secondary myocardial disease. Virus myocarditis and cardiomyopathy.In an attempt to prove the hypothesis that virus myocarditis may be a cause of idiopathic cardiomyopathy, clinical and experimental studies were performed. Eleven patients with a presumptive or proven diagnosis of virus myocarditis were followed for one and a half to 13 years after the acute illness. One patient died in the acute stage, six recovered completely and one continued to have bifascicular block without subjective symptoms. Three patients had exertional dyspnea, cardiomegaly and an abnormal ECG three to 13 years after the onset, and two of them had an enlarged LV cavity with reduced EF and histological changes in myocardial biopsies. The clinical picture in these three cases was similar to that seen in congestive cardiomyopathy. Clinical observations of the heart in an epidemic of coxsackie B 3 virus infection among school children revealed that 49 (19%) of 263 infected children had abnormal chest-X ray, electrocardiographic or echocardiographic findings one to 10 months after the onset, however none of them developed cardiomyopathy. In experimental infection of weanling golden hamsters with coxsackie B 3 virus (Nancy strain), all animals developed acute and severe myocarditis, and the virus was detected in the myocardium. Hemodynamic data suggested decreased contractility of the left ventricle in the acute stage. Histologically the heart showed focal myocardial necrosis and cellular infiltration without calcification, findings which resemble those in human doxsackie B virus myocarditi. Thus, the golden hamster is a better animal model than the mouse in studies on virus myocarditis and postcarditic cardiomyopathy.- - - - - - - - - - ranking = 8keywords = myocarditis (Clic here for more details about this article) |
6/16. Acute viral myocarditis, four cases in three weeks.Four cases of acute viral myocarditis were diagnosed within three weeks. The clinical features, electrocardiography, cardiac enzymes and other laboratory investigations are described.- - - - - - - - - - ranking = 5keywords = myocarditis (Clic here for more details about this article) |
7/16. Successful treatment of complete left bundle branch block complicating acute viral myocarditis employing Chinese herbs.A case of complete left bundle branch block complicating acute viral myocarditis successfully treated by Chinese herbal medicine is reported. Complete left bundle branch block may be less commonly encountered in myocarditis. Treatment by Chinese herbal medicine for 49 days was successful in the management of this conduction disturbance. follow-up studies, up to 3 months, produced normal electrocardiogram with good health.- - - - - - - - - - ranking = 6keywords = myocarditis (Clic here for more details about this article) |
8/16. Acute necrotising eosinophilic myocarditis.Loffler's endocarditis is a recognised complication of diseases associated with eosinophilia. Eosinophilic heart disease is usually chronic, but there is a rare acute variety. Three patients with an unusual form of eosinophilic heart disease characterised by acute necrotising eosinophilic myocarditis after a possible initial viral infection and underlying allergic diathesis are reported. In contrast to previously reported cases of acute Loffler's endocarditis there was no notable extracardiac pathology.- - - - - - - - - - ranking = 5keywords = myocarditis (Clic here for more details about this article) |
9/16. Simulation of acute myopericarditis by constrictive pericardial disease with endomyocardial fibrosis due to methysergide therapy.methysergide ( Sansert ) has been associated with numerous fibrotic disorders. In particular, multiple cardiac lesions have been described in cases where methysergide was thought to have played a causative role. A patient is described who presented with cardiac findings suggestive of acute myopericarditis . An inflammatory myocarditis was subsequently excluded by endomyocardial biopsy. Hemodynamic findings suggested the presence of constrictive pericarditis or restrictive cardiomyopathy, or both. Radiographic evidence of constrictive pericarditis and biopsy evidence of endocardial fibrosis were documented in this patient with a long history of interrupted methysergide therapy.- - - - - - - - - - ranking = 1keywords = myocarditis (Clic here for more details about this article) |
10/16. Viral myocarditis. Clinical, electrocardiographic and evolutive diversity.Five observations of severe viral myocarditis are presented. Diverse cardiac emergencies (pump failure, ventricular premature beats or tachycardia, left bundle branch block, trifascicular block, grade 2 or 3 a-v block, severe hypotension, etc.) as well as associated conditions (pericarditis, interstitial nephritis, pneumonia, pulmonary massive thromboembolism) could be found. The course of the disease was acute in three cases, subacute in one and chronic in another. Two patients died with severe pump failure (associated with pulmonary thromboembolism in one case). The clinical, evolutive and histologic aspects were in good correlation. These cases illustrate the clinical, electrocardiographic and evolutive diversity of viral myocarditis.- - - - - - - - - - ranking = 6keywords = myocarditis (Clic here for more details about this article) |
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