[Ventricular Extrasystole as Manifestation of Viral Myocarditis and Myopericarditis in Young Patients]

Ter Arkh. 2007;79(12):28-34.
[Article in Russian]

Abstract

Aim: To investigate relationship between frequent and complicated ventricular extrasystole (VE) in young patients and previous viral myocarditis (VM); to study VE long-term prognosis.

Material and methods: We examined 75 patients with mild and moderate myocarditis which developed after acute respiratory infections and other viral diseases (Coxsackie infection was serologically confirmed in 49%; flu, paraflu and adenoviral infection--in 8%). Acute myocarditis was diagnosed basing on the data of ECG, activity of cardiospecific enzymes and isoenzymes, x-ray, echocardiography, Holter ECG monitoring, exercise tests. The patients were followed up from 3 to 26 years (mean 14.6 years).

Results: Bigeminal polymorphic extrasystoles and bigemia sites persisted for the whole periods of observation. They could disappear at resting ECG but were registered at 24-h ECG monitoring in all the cases. Echocardiography detected fibrous alterations of the pericardium with its thickening in 89% cases. Exercise tolerance test at the end of the study recorded normal physical performance in 89.3% patients. This suggests a favorable disease outcome. Low physical performance, moderate dilation of the left ventricle and ejection fraction lowering to 48% requiring medication were observed only in 4 patients who were capable to work.

Conclusion: Frequent and complicated VE after viral myocarditis were present at resting ECG for many years in 42.3% patients. Holter 24-h ECG monitoring registered VE in all the examinees. 89% patients had fibrous lesions of the pericardium showing that viral myocarditis in most cases runs as myopericarditis, in some cases being subclinical.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral / analysis
  • Coxsackievirus Infections / complications*
  • Coxsackievirus Infections / physiopathology
  • Coxsackievirus Infections / virology
  • Echocardiography
  • Electrocardiography, Ambulatory
  • Enterovirus B, Human / immunology
  • Female
  • Follow-Up Studies
  • Heart Rate / physiology
  • Humans
  • Male
  • Myocarditis / complications*
  • Myocarditis / physiopathology
  • Myocarditis / virology
  • Pericarditis / complications*
  • Pericarditis / physiopathology
  • Pericarditis / virology
  • Prognosis
  • Ventricular Premature Complexes / diagnosis
  • Ventricular Premature Complexes / etiology*
  • Ventricular Premature Complexes / physiopathology

Substances

  • Antibodies, Viral