Viral Myocarditis and Dilated Cardiomyopathy: Mechanisms of Cardiac Injury, Inflammation, and Fibrosis

Author(s):  
Iwona Buskiewicz ◽  
Sally Huber ◽  
DeLisa Fairweather
Author(s):  
Fatemeh Baghalsafa ◽  
Hossein Neamatzadeh ◽  
Sedigheh Ekraminasab

Background: Several numbers of studies have reported that coronavirus disease-2019 (COVID-19) in infants and children have shown milder symptoms and a better prognosis than in adult patients. However, there is no sufficient evidence on the effect of cardiovascular involvement in COVID-19 in the infant. Case Report: Here, we report an infant infected with COVID-19 with the manifestations of dilated myocarditis. The patient was referred to Pediatric Emergency with lethargy and tachypnea. On physical examination, she had holosystolic murmur with grade 3/6. The laboratory examinations showed anemia as well as increased alkaline phosphatase (ALP) levels. Due to respiratory distress, she was intubated and put under mechanical ventilation. The diagnosis of COVID-19 infection was confirmed by real-time polymerase chain reaction (RT-PCR) using a pharyngeal specimen. Finally, dilated cardiomyopathy (DCM) was diagnosed and one day after hospitalization the infant was died due to complications of DCM. Conclusion: It seems that in the infant with severe underlying disease, even a mild COVID-19 infection, may be lethal. Focal viral myocarditis is a very rare condition described by localized disturbance of the myocardium occurring in ventricular dysfunction with significant morbidity and mortality. Thus, due to the possibility of cardiac injury in infected neonates with COVID-19 disease and the manifestation of myocarditis, effective measurement is recommended.


2016 ◽  
Vol 7 ◽  
Author(s):  
Li Yue-Chun ◽  
Chen Guang-Yi ◽  
Ge Li-Sha ◽  
Xing Chao ◽  
Tian Xinqiao ◽  
...  

2018 ◽  
Vol 34 (3) ◽  
pp. 230-236
Author(s):  
Alison White

Dilated cardiomyopathy (DCM) is a disease of the myocardium characterized by changes in cardiac chamber dimension and initial deterioration in systolic function accompanied by eventual diastolic function impairment with possible progression to cardiac failure. Early identification of ventricular dysfunction and etiology is imperative for the subsequent effective treatment of the cardiomyopathy process. One common cause of DCM is an infection from a viral insult that results in inflammation and consequent damage to the myocardium. Viral myocarditis may present as an acute or chronic illness. The clinical presentation of myocarditis demonstrates nonspecific symptomology that is variable between individuals. Accurate diagnosis of viral myocarditis relies upon various diagnostic testing methods to ascertain the origin of the infectious agent and resultant alterations in cardiovascular function. One such diagnostic testing method used in the detection of the presence and severity of DCM associated with viral myocarditis is echocardiography. The following case presentation demonstrates a dilated cardiomyopathy due to an acute myocarditis from Coxsackie B enterovirus evaluated with echocardiography.


2018 ◽  
Vol 2 ◽  
pp. 239784731877072
Author(s):  
David B Chapel ◽  
Aliya N Husain

Acute-onset heart failure in a young, otherwise healthy patient can be due to either acquired or congenital etiologies. While some diagnoses carry specific histologic hallmarks, many causes of myocardial injury culminate in the relatively nonspecific morphologic pattern of dilated cardiomyopathy. In such cases, a broad differential diagnosis and close clinicopathologic correlation are essential. Here we describe the acute and chronic histologic features of heart failure arising in the context of long-standing abuse of cocaine, alcohol, and marijuana. The mechanisms of cardiotoxicity are discussed for each drug, with particular emphasis on the amplified cardiac injury caused by concomitant cocaine and alcohol use. Although its histologic features are themselves nonspecific, correlation with clinical history, targeted studies to exclude alternative diagnoses, and careful morphologic examination permit confident diagnosis of cardiomyopathy secondary to polysubstance abuse.


Circulation ◽  
2006 ◽  
Vol 114 (6) ◽  
pp. 565-573 ◽  
Author(s):  
Stephane Heymans ◽  
Matthias Pauschinger ◽  
Armando De Palma ◽  
Angela Kallwellis-Opara ◽  
Susanne Rutschow ◽  
...  

Circulation ◽  
2007 ◽  
Vol 115 (1) ◽  
pp. 5-8 ◽  
Author(s):  
Yuichiro Maekawa ◽  
Maral Ouzounian ◽  
M. Anne Opavsky ◽  
Peter P. Liu

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