Coxsackie viral myocarditis: a clinical and echocardiographic study

Thirty two patients with acute onset of cardiac symptoms following an episode suggestive of viral infection, were studied. 11 patients had Coxsackie viral myocarditis. All had 4 fold rise of neutralising Coxsackie viral antibody titres on paired sera tested. Coxsackie B virus types 2 and 4 were commonly detected. Among the eleven patients, 8 presented with congestive heart failure, 2 with ventricular arrhythmias and one with chest pain and S3 gallop. All had ECG changes. Echocardiographic examination showed global left ventricular dysfunction in 7, regional wall motion abnormalities in 2 and normal left ventricular function in one. Serial echocardiographic examination showed progressive myocardial dysfunction in 3 and improvement in myocardial function in two patients. Two patients died during the follow up period. Echocardiography helped in assessing the course of patients with viral myocarditis.