Coxsackie B4 viral myocarditis can mimic acute myocardial infarction on ECG and cause extensive multiorgan damage including myocardial destruction and complete A-V block.
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Clinicians should consider viral myocarditis in atypical MI with multiorgan failure; case reports leave open questions on prevalence and management.
An autopsy case with Coxsackie B4 viral myocarditis associated with interstitial nephritis and hepatitis is presented. Electrocardiograms demonstrated significant ST elevation, complete A-V block (causing syncopal attacks), and subsequent deep QS pattern, which were simulated acute myocardial infarction. Autopsy findings revealed extensive myocardial destruction including the conduction system with inflammatory mononuclear cell infiltration. In addition to cardiac damage, persistent renal failure and high transaminase level suggested renal and hapatic involvements by viral infection, which were comf firmed at postmortem examination.
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Ohkita et al. (1977) studied this question.
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