Inflammation and the Onset of Myocardial Infarction

Editorials1 May 1985Inflammation and the Onset of Myocardial InfarctionDAVID H. SPODICK, M.D., D.Sc.DAVID H. SPODICK, M.D., D.Sc.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-5-699 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHow and why is an acute myocardial infarction precipitated in a patient who may not have had significant deterioration of structural and functional coronary abnormalities just before the infarction, and perhaps not for a long time before (1)? Numerous immediate mechanisms come to mind: the final addition to a relentless thrombotic silting over of an atheroma; sudden thrombosis owing to systemic, local arterial, or hemic changes; hemorrhage into, or rupture of, atherosclerotic plaque; and vasospasm with or without thrombosis. Regardless of the immediate "last straw," the question remains, What led to the infarction?A recent investigation of pericarditis of many...References1. BERTRAND M, LEFEBVRE J, LAISNE C, ROUSSEAU M, CARRE A, and LEKIEFFRE J. Coronary arteriography in acute transmural myocardial infarction. Am Heart J. 1979;97:61-9. CrossrefMedlineGoogle Scholar2. SPODICK D. Frequency of arrhythmias in acute pericarditis determined by Holter monitoring. Am J Cardiol. 1984;53:842-5. CrossrefMedlineGoogle Scholar3. SPODICK D, FLESSAS A, and JOHNSON M. Association of acute respiratory symptoms with the onset of acute myocardial infarction: prospective investigation of 150 consecutive patients and matched control patients. Am J Cardiol. 1984;53:481-2. CrossrefMedlineGoogle Scholar4. BAINTON D, JONES G, and HOLE D. Influenza and ischaemic heart disease—a possible trigger for acute myocardial infarction? Int J Epidemiol. 1978;7:231-9. Google Scholar5. BURCH G. Of URI and cardiomyopathy. Am Heart J. 1976;91:538. CrossrefMedlineGoogle Scholar6. BURCH G. Viral cardiomyopathy: syndrome of viral heart and neurologic disease. South Med J. 1973;66:1393-8. CrossrefMedlineGoogle Scholar7. DALY K, RICHARDSON P, and OLSEN E. Acute myocarditis: role of histological and virological examination in the diagnosis and assessment of immunosuppressive treatment. Br Heart J. 1984;51:30-5. CrossrefMedlineGoogle Scholar8. BOURNE G and WEDGWOOD J. Heart-disease and influenza. Lancet. 1959;1:1226-8. CrossrefMedlineGoogle Scholar9. BARLOW J, BENJAMIN J, COPANS H, and POCOCK W. Viruses and the heart. In: COHEN I, BEATON GR, MITCHELL D, eds. The South African Textbook of Sports Medicine. Johannesburg: University of Witwatersrand; 1979: 137-43. Google Scholar10. KRON J, LUCAS L, LEE T, and MCANULTY J. Myocardial infarction following an acute viral illness. Arch Intern Med. 1983;143:1466-7. CrossrefMedlineGoogle Scholar11. ENGLE M, ZABRISKIE J, SENTERFIT L, TAY D, and EBERT P. Immunologic and virologic studies in the postpericardiotomy syndrome. J Pediatr. 1975;87(6 pt 2):1103-8. CrossrefMedlineGoogle Scholar12. BELL E and GRIST N. Coxsackie virus infections in patients with acute cardiac disease and chest pain. Scott Med J. 1968;13:47-51. CrossrefMedlineGoogle Scholar13. HELIN M, SAVOLA J, and LAPINLEIMU K. Cardiac manifestations during a Coxsackie B5 epidemic. Br Med J. 1968;3:97-9. CrossrefMedlineGoogle Scholar14. HOSHINO T, MATSUMORI A, KAWAI C, and IMAI J. Ventricular aneurysms and ventricular arrhythmias complicating Coxsackie virus B1 myocarditis of Syrian golden hamsters. Cardiovasc Res. 1984;18:24-9. CrossrefMedlineGoogle Scholar15. O'NEILL D, MCARTHUR J, KENNEDY J, and CLEMENTS G. Coxsackie B virus infection in coronary care unit patients. J Clin Pathol. 1983;36:658-61. CrossrefMedlineGoogle Scholar16. NIKOSKELAINEN J, KALLIOMAKI J, LAPINLEIMU K, STENVIK M, and HALONEN P. Coxsackie B virus antibodies in myocardial infarction. Acta Med Scand. 1983;214:29-32. CrossrefMedlineGoogle Scholar17. LAU R. Coxsackie B virus infection in acute myocardial infarction and adult heart disease. Med J Aust. 1982;2:520-2. CrossrefMedlineGoogle Scholar18. GRIFFITHS P, HANNINGTON G, and BOOTH J. Coxsackie B virus infections and myocardial infarction: results from a prospective, epidemiologically logically controlled study. Lancet. 1980;1:1387-9. CrossrefMedlineGoogle Scholar19. WOOD S, ROGEN A, BELL E, and GRIST N. Role of Coxsackie B viruses in myocardial infarction. Br Heart J. 1978;40:523-5. CrossrefMedlineGoogle Scholar20. NICHOLLS A and THOMAS M. Coxsackie virus infection in acute myocardial infarction. Lancet. 1977;1:883-4. CrossrefMedlineGoogle Scholar21. WOODS J, NIMMO M, and MACKAY-SCOLLAY E. Acute transmural myocardial infarction associated with active Coxsackie virus B infection. Am Heart J. 1975;89:283-7. CrossrefMedlineGoogle Scholar22. GRIST N and BELL E. A six-year study of Coxsackie virus B infections in heart disease. J Hyg (Camb). 1974;73:165-72. CrossrefMedlineGoogle Scholar23. ABELMANN W. Viral myocarditis and its sequelae. Annu Rev Med. 1973;24:145-52. CrossrefMedlineGoogle Scholar24. ROBERTS W. Cardiomyopathy and myocarditis: morphologic features. Adv Cardiol. 1978;22:148-98. Google Scholar25. PONKA A, JALANKO H, PONKA T, and STENVIK M. Viral and mycoplasmal antibodies in patients with myocardial infarction. Ann Clin Res. 1981;13:429-32. MedlineGoogle Scholar26. VULLERS R, BULTMANN B, FISCHER H, and HAFERKAMP O. Influenza A virus infection, a precipitating factor for the major heart attack. MMW. 1980;122:1415-7. Google Scholar27. PARRILLO J, ARETZ H, PALACIOS I, FALLON J, and BLOCK P. The results of transvenous endomyocardial biopsy can frequently be used to diagnose myocardial diseases in patients with idiopathic heart failure: endomyocardial biopsies in 100 consecutive patients revealed a substantial incidence of myocarditis. Circulation. 1984;69:93-101. CrossrefMedlineGoogle Scholar28. TAKE M, SEKIGUCHI M, HIROE M, and KIROSAWA K. Long-term follow-up of electrocardiographic findings in patients with acute myocarditis proven by endomyocardial biopsy. Jpn Circ J. 1982;46:1227-34. CrossrefMedlineGoogle Scholar29. SAFFITZ J, SCHWARTZ D, and SOUTHWORTH W. Coxsackie viral myocarditis causing transmural right and left ventricular infarction without coronary narrowing. Am J Cardiol. 1983;52:644-7. CrossrefMedlineGoogle Scholar30. DESA'NETO A, BULLINGTON J, BULLINGTON R, DESSER K, and BENCHIMOL A. Coxsackie B5 heart disease: demonstration of inferolateral wall myocardial necrosis. Am J Med. 1980;68:295-8. CrossrefMedlineGoogle Scholar31. CHANDRARATNA P, NIMALASURiYA A, REID C, COHN S, and RAHIMTOOLA S. Left ventricular asynergy in acute myocarditis. JAMA. 1983;250:1428-30. CrossrefMedlineGoogle Scholar32. HEIKKILA J and KARJALAINEN J. Evaluation of mild acute infectious myocarditis. Br Heart J. 1982;47:381-91. CrossrefMedlineGoogle Scholar33. MIKLOZEK C and ABELMANN W. Viral myopericarditis presenting as acute myocardial infarction Abstract. Circulation. 1982;64(suppl IV):IV-25. Google Scholar34. SPODICK D. Q-wave infarction versus ST-infarction: nonspecificity of ECG criteria for differentiating transmural and nontransmural lesions. Am J Cardiol. 1983;51:913-5. CrossrefMedlineGoogle Scholar35. LERNER A. Coxsackievirus myocardiopathy. J Infect Dis. 1969;120:496-9. CrossrefMedlineGoogle Scholar36. LANSDOWN A. Viral infections and diseases of the heart. Prog Med Virol. 1978;24:70-113. MedlineGoogle Scholar37. OLSEN E. Myocarditis—a case of mistaken identity? Br Heart J. 1983;50:303-11. CrossrefMedlineGoogle Scholar38. JAMES T. Pathology of small coronary arteries. Am J Cardiol. 1967;20:679-91. CrossrefMedlineGoogle Scholar39. BURCH G and SHEWEY L. Viral coronary arteritis and myocardial infarction. Am Heart J. 1976;92:11-4. CrossrefMedlineGoogle Scholar40. MELISH M. Kawasaki syndrome: a new infectious disease? J Infect Dis. 1981;143:317-24. CrossrefMedlineGoogle Scholar41. FURUSHO K, SATO K, and SOEDA T. High-dose intravenous gammaglobulin for Kawasaki disease Letter. Lancet. 1983;2:1359. CrossrefMedlineGoogle Scholar42. KAWAI C, MATSUMORI A, KUMAGAI N, and TOKUDA M. Experimental Coxsackie virus B3 and B4 myocarditis in mice. Jpn Circ J. 1978;42:43-7. CrossrefMedlineGoogle Scholar43. ECKSTEIN R, MEMPEL W, and BOLTE H. Reduced suppressor cell activity in congestive cardiomyopathy and in myocarditis. Circulation. 1982;65:1224-9. CrossrefMedlineGoogle Scholar44. RAO A, MINTZ P, and LAVINE S. Coagulant activities of platelets in coronary artery disease. Circulation. 1984;69:15-21. CrossrefMedlineGoogle Scholar45. MARTIN J, PLUMB J, KILBEY R, and KISHK Y. Changes in volume and density of platelets in myocardial infarction. Br Med J Clin Res. 1983;287:456-9. CrossrefMedlineGoogle Scholar46. ROBERTSON R, ROBERTSON D, FRIESINGER G, TIMMONS S, and HAWIGER J. Platelet aggregates in peripheral and coronary-sinus blood in patients with spontaneous coronary-artery spasm. Lancet. 1980;2:829-31. CrossrefMedlineGoogle Scholar47. NEILL W, WHARTON J, FLURI-LUNDEEN J, and COHEN I. Acute coronary insufficiency—coronary occlusion after intermittent ischemic attacks. N Engl J Med. 1980;302:1157-62. CrossrefMedlineGoogle Scholar48. TERADA H, BALDINI M, EBBE S, and MADOFF M. Interaction of influenza virus with blood platelets. Blood. 1966;28:213-28. CrossrefMedlineGoogle Scholar49. MOVAT H, MUSTARD J, TAICHMAN N, and URIUHARA T. Platelet aggregation and release of ADP, serotonin and histamine associated with phagocytosis of antigen-antibody complexes. Proc Soc Exp Biol Med. 1965;120:232-7. CrossrefMedlineGoogle Scholar50. OLIVA P and BRECKINRIDGE J. Artériographie evidence of coronary arterial spasm in acute myocardial infarction. Circulation. 1977;56:366-74. CrossrefMedlineGoogle Scholar51. MASERI A, L'ABBATE A, and BAROLDI G. Coronary vasospasm as a possible cause of myocardial infarction: a conclusion derived from the study of "preinfarction" angina. N Engl J Med. 1978;299:1271-7. CrossrefMedlineGoogle Scholar52. GORDON T and THOM T. The recent decrease in CHD mortality. Prev Med. 1975;4:115-25. CrossrefMedlineGoogle Scholar53. BURCH P. Diet and ischaemic heart disease Letter. Lancet. 1983;2:743. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: DAVID H. SPODICK, M.D., D.Sc.Affiliations: St. Vincent Hospital University of Massachusetts Medical School Worcester, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byImpact of diabetes on fibrinogen levels and its relationship with platelet reactivity and coronary artery disease: A single-centre studyThe association of chronic apical periodontitis and endodontic therapy with atherosclerosisAcute respiratory tract infections: A potential trigger for the acute coronary syndromeRelationship between White Blood Cell Count and Framingham Risk Score in Asymptomatic MenTransgenic human C-reactive protein is not proatherogenic in apolipoprotein E-deficient miceA rare case of acute 'infective' myocardial infarction triggered by acute parvovirus B19 myocarditisDecreased Recognition of the Post-Myocardial Infarction (Dressler) Syndrome in the Postinfarct SettingThe predictive value of white blood cell count on the success of primary percutaneous intervention of the left anterior descending artery in patients admitted with acute anterior wall myocardial infarctionLeukocytes and coronary heart diseaseC-reactive protein and cardiovascular disease: new insights from an old moleculeNonbleeding Clotting: The Role of the Coagulation System in InflammationTreatment of Periodontitis by Local Administration of Minocycline Microspheres: A Controlled TrialDetection of Helicobacter pylori in Human Carotid Atherosclerotic PlaquesPotential effects of flavonoids on the etiology of vascular diseasePolymyalgia rheumatica in a patient with acute tubulointerstitial nephritis due to Sjögren's syndromePeriodontitis: A Risk Factor for Coronary Heart Disease?Acute respiratory-tract infections and risk of first-time acute myocardial infarctionMore Information on Infection and InfarctionFibrinogen and Cardiovascular RiskEpidemiological Study of Periodontal Disease and White Blood Cell Count among Employees in a CompanyPrecipitants of Brain InfarctionAngiotensin converting enzyme gene deletion allele is independently and strongly associated with coronary atherosclerosis and myocardial infarction.Metabolic Abnormalities in Cardiac IschemiaMyocardial infarction or inflammation?Fibrinogen: Its Emerging Role as a Cardiovascular Risk FactorAcute myocardial infarction in an adolescent with normal coronary arteriesFibrinogen: An Important Risk Factor for Atherothrombotic DiseasesDental infections and coronary atherosclerosisThe role of fibrinogen as a cardiovascular risk factorMyocarditis mimicking myocardial infarctionChlamydia pneumoniae-specific circulating immune complexes in patients with chronic coronary heart disease.Chlamydial infections of the heartThe white blood cell count and risk for coronary heart diseaseCirculating immune complexes containing chlamydial lipopolysaccharide in acute myocardial infarctionThe role of leukocytes in ischemic damage, reperfusion injury and repair of the myocardiumViral and bacterial infections in patients with acute myocardial infarctionAssociation between dental health and acute myocardial infarction.Preceding infection as an important risk factor for ischaemic brain infarction in young and middle aged patientsLeukocytes, Thrombosis, and Unstable AnginaTraining clinical neuroscientistsImmulogical challenge with virus initiates leukotriene C4 production in the heart and induces cardiomyolysis in guinea pigs 1 May 1985Volume 102, Issue 5Page: 699-702KeywordsAcute myocardial infarctionAtheromasHemorrhageInfarctionInflammationMyocardial infarctionThrombosis ePublished: 1 December 2008 Issue Published: 1 May 1985 PDF downloadLoading ...