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Parvovirus B19 infection mimicking acute myocardial infarction

Uwe Kühl1, Matthias Pauschinger, Thomas Bock

  • 1Medical Clinic II, Department of Cardiology, University Hospital Benjamin Franklin, Berlin, Germany. dcmkuehl@zedat.fu-berlin.de

Circulation
|August 20, 2003
PubMed
Abstract

Insights

Parvovirus B19 (PVB19) DNA was frequently detected in patients with acute myocarditis mimicking heart attacks. This suggests PVB19 is a significant pathogen in myocarditis, alongside enteroviruses and adenoviruses.

Area of Science:

  • Cardiology
  • Virology
  • Pathogen Detection

Background:

  • Myocarditis and dilated cardiomyopathy are often linked to enteroviruses (EVs) and adenoviruses (ADVs).
  • This study investigates the role of parvovirus B19 (PVB19) in acute myocarditis cases.

Observation:

  • Twenty-four patients presenting with chest pain, ST-segment elevation, or T-wave inversion, and normal coronary anatomy were studied.
  • Clinical presentation mimicked acute myocardial infarction, with elevated cardiac enzymes and C-reactive protein.
  • Wall motion abnormalities were present in 18 patients, but histological analysis showed minimal signs of active myocarditis in most.

Findings:

  • Viral genomes were detected in 71% of patients.
  • Parvovirus B19 (PVB19) genomes were found in 12 patients (50%), enteroviruses (EVs) in 3 (12.5%), and adenoviruses (ADVs) in 2 (8.3%).
  • Follow-up biopsies confirmed the persistence of PVB19, EV, and ADV genomes in a significant proportion of patients.

Implications:

  • Viral detection in myocardial biopsies is crucial for diagnosing acute myocarditis that mimics myocardial infarction.
  • Parvovirus B19 (PVB19) emerges as a frequent pathogen in acute myocarditis.
  • Understanding the viral etiology of myocarditis aids in targeted treatment and management strategies.

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