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A rare case of acute 'infective' myocardial infarction triggered by acute parvovirus B19 myocarditis

Nature Clinical Practice Cardiovascular Medicine volume 2, pages 167–171 (2005)Cite this article

Abstract

Background A 25-year-old obese male (BMI 31.9 kg/m2) presented with atypical chest pain of sudden onset that was indistinguishable from acute myocardial infarction. He had tachycardia (104 beats/min) and dyspnea at a low level of exercise. He had no previous cardiac history, but his cardiovascular risk profile included a familial predisposition, smoking and hypertension.

Investigations Electrocardiogram, laboratory testing, chest radiography, echocardiography, coronary angiography, intravascular ultrasonography and endomyocardial biopsy.

Diagnosis Acute myocardial infarction and parvovirus-B19-positive myocarditis.

Management Percutaneous transluminal coronary angioplasty with intracoronary abciximab, heparin and nitroglycerin infusion.

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Figure 1: Initial electrocardiogram of 25-year-old patient with dyspnea on low-level exercise.
Figure 2: Coronary angiography and intravenous ultrasound scans.
Figure 3: Microscopy of myocardial biopsy samples.
Figure 4: Viral DNA analysis of endomyocardial biopsy samples.

References

  1. Fournier JA et al. (2004) Long-term prognosis of patients having acute myocardial infarction when ≤40 years of age. Am J Cardiol 94: 989–992

    Article  Google Scholar 

  2. Pauschinger M et al. (2004) Viral heart disease: molecular diagnosis, clinical prognosis, and treatment strategies. Med Microbiol Immunol 193: 65–69

    Article  CAS  Google Scholar 

  3. Bowles NE et al. (2003) Detection of viruses in myocardial tissues by polymerase chain reaction. Evidence of adenovirus as a common cause of myocarditis in children and adults. J Am Coll Cardiol 42: 466–472

    Article  Google Scholar 

  4. Kuhl U et al. (2003) Parvovirus B19 infection mimicking acute myocardial infarction. Circulation 108: 945–950

    Article  Google Scholar 

  5. Young NS et al. (2004) Mechanisms of Disease: Parvovirus B19. N Engl J Med 350: 586–597

    Article  CAS  Google Scholar 

  6. Bultmann BD et al. (2004) Parvovirus B19. N Engl J Med 350: 2006–2007

    Article  Google Scholar 

  7. Pankuweit S et al. (2004) Parvovirus B19 genome in endomyocardial biopsy specimen. Circulation 109: 179

    Article  Google Scholar 

  8. Woods JD et al. (1975) Acute transmural myocardial infarction associated with active Coxsackie virus B infection. Am Heart J 89: 283–287

    Article  CAS  Google Scholar 

  9. Pankuweit S et al. (2003) Prevalence of the parvovirus B19 genome in endomyocardial biopsy specimens. Hum Pathol 34: 497–503

    Article  Google Scholar 

  10. Spodick DH et al. (1985) Inflammation and the onset of myocardial infarction. Ann Intern Med 102: 699–702

    Article  CAS  Google Scholar 

  11. Movat HZ et al. (1985) Severe microvascular injury induced by lysosomal releasates of human polymorphonuclear leukocytes. Increase in vasopermeability, hemorrhage, and microthrombosis due to degradation of subendothelial and perivascular matrices. Am J Pathol 121: 404–417

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Burch GE et al. (1976) Viral coronary arteritis and myocardial infarction. Am Heart J 92: 11–14

    Article  CAS  Google Scholar 

Download references

Acknowledgements

Written consent for publication was obtained from the patient reported in this case study.

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Author notes

  1. Achim Gutersohn, Thomas Bartel, Raimund Erbel and Ulrich Zimmermann: A Gutersohn, T Bartel and R Erbel are Cardiologists and U Zimmermann a Nephrologist

Authors and Affiliations

  1. the University Duisburg-Essen, Germany

    Achim Gutersohn, Ulrich Zimmermann, Thomas Bartel & Raimund Erbel

Authors
  1. Achim Gutersohn
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  2. Ulrich Zimmermann
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  3. Thomas Bartel
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Correspondence to Achim Gutersohn.

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The authors declare no competing financial interests.

Glossary

CARDIOTHORACIC RATIO

Transverse cardiac diameter divided by transverse chest diameter (at the widest point of the rib cage); >50% is considered abnormal in adults

TIMI III FLOW

Indicates normal blood flow on the Thrombolysis in Myocardial Infarction (TIMI) risk classification (0–I, no flow; II, slow flow; III, normal flow)

MYOCARDITIS

Inflammatory disorder of the myocardium with necrosis of myocardial tissue and associated inflammatory infiltrate

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Gutersohn, A., Zimmermann, U., Bartel, T. et al. A rare case of acute 'infective' myocardial infarction triggered by acute parvovirus B19 myocarditis. Nat Rev Cardiol 2, 167–171 (2005). https://doi.org/10.1038/ncpcardio0126

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