Acute viral myocarditis

Acute viral myocarditis

Acute viral myocarditis was often due to Coxsackie B virus or echovirus in the pre covid era. Usually it is a self-limited infection in young people. But at times it can be fulminant and catastrophic. Rarely it can go into a chronic dilated cardiomyopathy like phase with delayed recovery if at all. The mechanism is thought to be myocyte death and fibrosis. Immune mediated myocardial injury has also been postulated. Myocarditis often follows an upper respiratory illness. Chest pain with or without signs of heart failure may occur. ECG shows sinus tachycardia and nonspecific ST – T changes and sometimes intraventricular conduction defects. Echocardiogram demonstrates the contractile dysfunction in myocarditis. The contractile dysfunction could be regional or global. Magnetic resonance imaging is now an important modality of investigation for myocarditis. Myocardial biopsy though seldom done in cases of myocarditis, may demonstrate giant cells.