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Clinical presentation and long-term follow-up of perimyocarditis

Alessandra Buiatti1, Marco Merlo, Bruno Pinamonti

  • 1Cardiovascular Department, Ospedali Riuniti and University of Trieste, Trieste, Italy. elam4@libero.it

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|May 31, 2012
PubMed
Abstract

Insights

Perimyocarditis (PMY) generally has a favorable long-term prognosis, with most patients experiencing symptom resolution and no significant cardiac complications. Recurrences are possible but typically do not lead to severe heart issues.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • The natural history and prognostic factors of perimyocarditis (PMY) require further elucidation.
  • Understanding PMY's clinical course is crucial for effective patient management and stratification.

Purpose of the Study:

  • To analyze clinical and laboratory data of PMY patients at diagnosis and during follow-up.
  • To assess the natural history and prognostic stratification of PMY, considering various etiologies.

Main Methods:

  • 62 consecutive PMY patients (84% idiopathic) were enrolled between 2002 and 2010.
  • Diagnosis was based on clinical and laboratory data, including elevated troponin I.
  • Follow-up data was available for 59 patients (95%) after a mean of 1635 days.

Main Results:

  • Chest pain (95%) and flu-like syndrome (58%) were common presenting symptoms.
  • No patients presented with heart failure; mild left ventricular dysfunction or wall motion abnormalities were observed in some.
  • At 1-year follow-up, no deaths, heart failure, or echocardiographic abnormalities occurred. NSAIDs achieved 95% clinical resolution.
  • Seven patients (12%) had recurrences without developing constrictive pericarditis or heart failure.

Conclusions:

  • PMY demonstrates a benign mid- to long-term outcome irrespective of initial presentation, etiology, or relapses.
  • The findings suggest a limited role for endomyocardial biopsy in managing PMY.
  • Therapeutic strategies focusing on NSAIDs yield high rates of clinical resolution.

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