Viral myocarditis and dilated cardiomyopathy: mechanisms, manifestations, and management

Viral infection of the heart is relatively common and usually of little consequence. It can, however, lead to substantial cardiac damage and severe acute heart failure. It can also evolve into the progressive syndrome of chronic heart failure. Recent studies have gone some way towards unravelling th...

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Bibliographic Details
Published in:Postgraduate medical journal 2001-01, Vol.77 (903), p.4-10
Main Authors: Kearney, M T, Cotton, J M, Richardson, P J, Shah, A M
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Biological and medical sciences
Biopsy - methods
Cardiology. Vascular system
Cardiomyopathy, Dilated - immunology
Cardiomyopathy, Dilated - therapy
Cardiomyopathy, Dilated - virology
Causes of
coxsackie B virus
Coxsackievirus Infections - complications
Coxsackievirus Infections - therapy
dilated cardiomyopathy
Echocardiography - methods
Electrocardiography - methods
Enterovirus B, Human
Evaluation
Female
Heart
Heart failure
Human viral diseases
Humans
Infection
Infectious diseases
Killer Cells, Natural - immunology
Male
Medical sciences
Myocarditis
Myocarditis - immunology
Myocarditis - therapy
Myocarditis - virology
Myocarditis. Cardiomyopathies
Nitric Oxide - physiology
Physiological aspects
Review
Risk Factors
Viral cardiopathies
Viral diseases
Virus diseases
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Summary:Viral infection of the heart is relatively common and usually of little consequence. It can, however, lead to substantial cardiac damage and severe acute heart failure. It can also evolve into the progressive syndrome of chronic heart failure. Recent studies have gone some way towards unravelling the complex mechanisms underlying the heart muscle damage that occurs after viral infection. These studies have lent support to both immune and viral mediated (independent of an immune response) cardiac damage. Acute myocarditis can present in various ways, and it may be a cause of sudden death in an otherwise healthy young adult. New treatments for viral heart disease are awaited. In the meanwhile, the haemodynamic support of patients with acute left ventricular failure caused by myocarditis should be aggressive, to allow for the possibility of spontaneous recovery. Contemporary trials of treatment in chronic heart failure secondary to dilated cardiomyopathy support the use of angiotensin converting enzyme inhibitors, β adrenoceptor blockers, and spironolactone in such patients.
ISSN:0032-5473
1469-0756
DOI:10.1136/pmj.77.903.4