Coxsackie B4 virus infection in two siblings led to progressive heart failure and widespread post-myocarditic scarring, suggesting familial factors may be important in dilated cardiomyopathy.
Case Report (n=2)
The findings suggest that Coxsackie myocarditis can lead to dilated cardiomyopathy and that familial factors may play an important role in susceptibility.
Two brothers, aged 7 and 9, presented 4 years apart with progressive heart failure following a probable viral infection. Electrocardiograms of both showed widespread precordial Q waves. Cardiac catheterization in each case revealed almost equal right atrial, right ventricular and pulmonary artery pressures and poorer contraction of the right than left ventricle. High neutralizing antibody titres to Coxsackie B4 virus were found in the siblings and their mother. Widespread post-myocarditic scarring of both ventricles was found at autopsy on the elder brother. These findings provide further evidence that Coxsackie myocarditis accounts for some cases of dilated cardiomyopathy and suggest that familial factors may be important.
Shapiro et al. (Sat,) conducted a case report in Myocarditis leading to chronic heart failure (n=2). Coxsackie B4 virus infection was evaluated on Progressive heart failure and dilated cardiomyopathy. Coxsackie B4 virus infection in two siblings led to progressive heart failure and widespread post-myocarditic scarring, suggesting familial factors may be important in dilated cardiomyopathy.