1/26. Myocardial recovery after mechanical support for acute myocarditis: is sustained recovery predictable?BACKGROUND: At present, myocardial recovery with mechanical support for acute myocarditis is a more frequently observed issue. However, predictive parameters of a sustained myocardial recovery are still under investigation. methods: Two recent cases of mechanical support for acute lymphocytic myocarditis with two different outcomes are reported. literature about this disease and predictability of a sustainable myocardial recovery are reviewed. RESULTS: Acute lymphocytic myocarditis is an individual entity whose outcome is associated with the importance of healed cell damage. Unfortunately, there are no available means of quantifying the fibrotic scar and endomyocardial biopsy has a high percentage of false-negative results. Echocardiographic assessment of systolic and diastolic cardiac function is difficult while under mechanical support and its significance is not obvious. Forthcoming development of Doppler could better correlate myocardial contractility and histology to be predictive of a sustained recovery after acute myocarditis under mechanical support. CONCLUSIONS: Long-lasting recovery after mechanical support for acute myocarditis remains unpredictable in our experience. More predictive factors are needed.- - - - - - - - - - ranking = 1keywords = still (Clic here for more details about this article) |
2/26. Fatal intrauterine adenoviral endomyocarditis with aortic and pulmonary valve stenosis: diagnosis by polymerase chain reaction.We report a case of fatal hydrops fetalis owing to adenoviral endomyocarditis with aortic and pulmonary valve stenosis. A 1850-g macerated male stillborn delivered 1 week after fetal ultrasonography showed hydrops, cardiomegaly, and possible aortic valve stenosis. autopsy confirmed hydrops and showed thickened, fibrotic semilunar valves with stenosis. The myocardium was focally fibrotic with areas of calcification. polymerase chain reaction study of myocardial and aortic valve tissue was positive for adenovirus. Intrauterine viral myocarditis has been reported only rarely, but cases owing to Coxsackie B virus, adenovirus, and parvovirus B19 have appeared in the literature. With the exception of rubella, viral causation of significant valvular lesions in humans has received scanty support in the literature. This report suggests a broader group of causative agents. HUM PATHOL 31:1433-1435.- - - - - - - - - - ranking = 1keywords = still (Clic here for more details about this article) |
3/26. recurrence of myocarditis presenting as pacing and sensing failure after implantation of a permanent pacemaker at first onset.A 31-year-old woman was admitted to hospital with loss of consciousness and generalized convulsions. electrocardiography (ECG) showed complete atrioventricular block (AV block) with a pulse rate of 30 beats/min. Endomyocardial biopsy from the right ventricle showed massive necrosis and degeneration of myocardial cells with extensive infiltration of lymphocytes into the interstitial space. These pathological findings suggested fulminant myocarditis. Following glucocorticoid therapy, the patient became asymptomatic, but the AV block did not resolve completely and a bifocal pacemaker was implanted. However, similar symptoms recurred 7 years later. An ECG showed pacing and sensing failure linked to an increase in the pacing threshold and a decrease in the sensing threshold. Endomyocardial biopsy from the right ventricle again showed interstitial infiltration with lymphocytes and eosinophils. After glucocorticoid therapy, she became asymptomatic once more, and the improvement in the pacing and sensing failure, and cardiomegaly, was satisfactory. This patient represents a very rare case of recurrence of acute myocarditis without progression, as much as 7 years after its first occurrence. Glucocorticoid therapy was still effective in treating the recurrent myocarditis presenting with pacing and sensing failure.- - - - - - - - - - ranking = 1keywords = still (Clic here for more details about this article) |
4/26. encephalitis and myocarditis in a child with acute lymphoblastic leukemia: role of coxsackievirus B5?Enteroviruses are common causes of viral encephalitis in childhood and the most common cause of myocarditis. The prognosis is good with exception of the immunocompromised children who are at higher risk with increased mortality. A case of a 7-year-old boy with acute lymphoblastic leukemia and coxsackievirus B5-associated encephalitis and myocarditis is described. The boy was in complete remission and coxsackievirus B5 infection occurred 22 months after the beginning of chemotherapy. The clinical manifestations were fever, seizures, and altered consciousness. He underwent only supportive treatment. He had an excellent outcome; 2 years later he is still in complete remission with normal electroencephalogram and normal cardiac function.- - - - - - - - - - ranking = 1keywords = still (Clic here for more details about this article) |
5/26. Analysis of the presence of trypanosoma cruzi in the heart tissue of three patients with chronic Chagas' heart disease.It is still unclear to what extent myocarditis-associated, chronic Chagas' heart disease is due to persisting trypanosoma cruzi. In the present study, we have analyzed tissue samples from the hearts of three patients with this disease. in situ hybridization provided little evidence for the presence of intact T. cruzi even at sites of strong inflammation. Nevertheless, micromanipulation techniques detected remnants of both T. cruzi kinetoplast dna and nuclear dna. trypanosoma cruzi dna was also detected in single macrophages dissected directly from frozen heart tissue sections. Thus, this analysis demonstrates that T. cruzi kinetoplast dna and nuclear dna are widely dispersed in the heart tissue, although in low amounts. Since we rarely detected intact T. cruzi parasites during the chronic phase of Chagas' heart disease, we can exclude heart tissue as a major parasite reservoir.- - - - - - - - - - ranking = 1keywords = still (Clic here for more details about this article) |
6/26. Successful electrical pacing for complete heart block complicating diphtheritic myocarditis.A case of severe diphtheria complicated by myocarditis and neurorespiratory paralysis is reported. The myocarditis manifested with severe conduction disturbances including left bundle-branch block and high grade second degree atrioventricular block leading to Adams-Stokes attacks. Temporary transvenous electrical pacing for.3 days was successful in the management of this complication, but positive pressure ventilation was later required for respiratory paralysis. This case illustrates the potential value of electrical pacing in diphtheritic myocarditis. Sporadic cases of diphtheria still occur and the case fatality ratio remains at 10%, much of which is related to the occurrence of myocarditis.- - - - - - - - - - ranking = 1keywords = still (Clic here for more details about this article) |
7/26. Early detection and successful therapy of fulminant chlamydia pneumoniae myocarditis.We report a case involving a young female patient with chlamydia pneumoniae myocarditis who required assist device therapy for acute heart failure. early diagnosis was provided by endomyocardial biopsy, and tailored antibiotic therapy facilitated quick recovery of myocardial function. This is the first case to report detecting C pneumoniae as the pathogen responsible for fulminant myocarditis while the patient was still alive and to report long-term follow-up data.- - - - - - - - - - ranking = 1keywords = still (Clic here for more details about this article) |
8/26. Myopericarditis revealing adult-onset Still's disease.We report the case of a 33 year-old man presenting with fever, arthralgias, sore throat, dyspnea and chest pain. Myopericarditis was diagnosed on the basis of electrocardiogram, echocardiography and cardiac magnetic resonance imaging (MRI). The dramatic increase in ferritinemia suggested the diagnosis of adult-onset Still's disease (AOSD), which could be established according to criteria of Yamaguchi. Rapid improvement occured under corticosteroids. myocarditis is very rare in AOSD, pericarditis being more frequent. We report herein the first description of AOSD associated myocarditis evidenced by cardiac MRI.- - - - - - - - - - ranking = 0.58842210811438keywords = adult-onset (Clic here for more details about this article) |
9/26. adult-onset acute rheumatic fever: possible resurgence in southern taiwan.BACKGROUND: By the late 1980s, acute rheumatic fever (ARF) had become a rare disease in taiwan. The low prevalence rate in this area is attributed to a better economic status, which has led to improved public health and adequate medical services. OBJECTIVES: The increasing number of patients with adult-onset ARF in the united states described in the literature prompted us to evaluate the cases diagnosed in our medical center. methods: A retrospective chart review was performed for patients with arthritis from July 1988 to October 2004. To be included, patients had to meet revised Jones criteria. RESULTS: Three adult patients with ARF have been diagnosed since June 2001, with no childhood ARF being diagnosed. All cases presented with migratory polyarthritis, whereas 1 had erythema marginatum and transient carditis. These patients responded well to treatment with antibiotics and nonsteroidal antiinflammatory drugs. CONCLUSIONS: Clinicians must provide careful assessment and treatment to patients presenting with acute pharyngitis. A possible resurgence of ARF can be eradicated by primary prevention of streptococcal pharyngitis.- - - - - - - - - - ranking = 0.11768442162288keywords = adult-onset (Clic here for more details about this article) |
10/26. Cytomegalovirus myocarditis in transplanted heart verified by endomyocardial biopsy.cytomegalovirus infections are common disorders after heart transplantations. Manifestation of the virus without a clinical disease is still more prevalent. Differentiation of clinical infections from cytomegalovirus activations without major pathogenetic importance issues a challenge in the follow-up of patients with cardiac transplants. The case describes a 56-year-old female patient with a multiple organ lethal infection and myocarditis due to cytomegalovirus diagnosed during life with endomyocardial biopsy.- - - - - - - - - - ranking = 1keywords = still (Clic here for more details about this article) |
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