Key result
Endomyocardial biopsy diagnoses borderline myocarditis in a 25-year-old female with palpitations and mild systolic dysfunction.
Why the study?
The link between recurrent viral myocarditis and the development of dilated cardiomyopathy remains to be elucidated.
Case Report (n=1)
This case report describes the clinical and histological presentation of borderline myocarditis in a young female, highlighting the potential link between recurrent viral myocarditis and dilated cardiomyopathy.
Suggests histopathology may refine prognosis in young women with viral cardiomyopathy; leaves open validation in larger cohorts.
myocarditis; dilated cardiomyopathy; viral cardiomyopathy; histopathology; prognosis A 25-year-old healthy, young female radiologist first presented with palpitations in 2013.Initial ECG revealed a sinus rhythm with low voltage waves and a Q wave in aVL.A 24-h Holter monitoring revealed w500 supraventricular and w500 ventricular extrasystoles with RBBB morphology and without runs or pauses.The echocardiogram showed a nondilated left ventricle with mild global systolic dysfunction and a left ventricular ejection fraction (LVEF) of 45%-50%.Extended laboratory evaluation results including hstroponin and C-reactive protein was unremarkable.The patient started HF treatment (ramipril 5 mg od, carvedilol 12.5 mg bid) and was referred to Onassis Heart Failure Center for further evaluation.The patient underwent coronary arteriography, which excluded coronary artery disease and right endomyocardial biopsy (EMB).Five myocardial tissue specimens were received for histology, immunohistochemistry, and molecular biology.Histology revealed atrophied cardiomyocytes without areas of acute inflammation or necrosis and mild to moderate fibrosis, resulting in the histological diagnosis of borderline myocarditis.Immunohistochemical staining for CD11a, CD11b, CD3, CD54, HLA-1, and perforin depicted moderate infiltration of lymphocytes (CD11a, CD3) and macrophages (CD11b), which was associated with an enhanced endothelial expression of adhesion molecule
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Nikolaou et al. (2017) conducted a case report in Recurrent viral myocarditis / dilated cardiomyopathy (n=1). Heart failure treatment and endomyocardial biopsy was evaluated. A 25-year-old female presenting with palpitations and mild global systolic dysfunction was diagnosed with borderline myocarditis via endomyocardial biopsy showing inflammatory infiltration.
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