Coxsackie B virus infection in acute myocardial infarction and adult heart disease

Myocarditis confirmed by biopsy presenting as acute myocardial infarction.

“…These data are not consistent and vary with the patient population, assay method, and sampling times. '3 14 The confusion surrounding the association of myocardial infarction with myocarditis is perpetuated by the lack of unequivocal documentation of the latter process after acute myocardial infarction occurring in the setting of acute viral infection.…”

Coxsackie viral myocarditis

“…A 'moderate order association' (Lerner et al, 1975) of Coxsackie virus B with myocarditis has been made by the correlation of neutralizing antibody titres or isolation of the virus from rectal or nasopharyngeal swabs with acute myocarditis (Bell & Grist, 1968;Freij et al, 1970;Smith, 1970;Koontz & Ray, 1971;Schmidt et al, 1973;Toshima et al, 1979). The incidence of elevated titres to enteroviruses is greater in patients with chronic congestive heart failure due to primary myocardial disease than in the general population of patients with heart disease of other aetiology (Table III) (Cambridge et al, 1979;Falase et al, 1979;Kitaura, 1981a;Lau, 1982), and the progression from acute CVB myocarditis to a chronic dilated cardiomyopathy has only been described in isolated patients (Burch & Colcolough, 1969;Frenkel, 1972;Rose, 1973;Barson et al, 1981;Morita et al, 1983). Also, in patients without clinical myocarditis, from whom Coxsackie B virus was isolated in the nasopharynx, a high incidence of subsequent chronic congestive heart failure has been documented (Orinius, 1968 Progressive clinical syndrome initiated with viral myocarditis culminating in dilated cardiomyopathy.…”