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From Streptococcal Pharyngitis/Tonsillitis to Myocarditis: A Systematic Review
Lukas Schmutzler1, Moritz Mirna1, Uta C Hoppe1
1Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria.
Journal of Cardiovascular Development and Disease
|June 23, 2022
Summary
Myocarditis after group A streptococcal infections is rare but presents with chest pain and ECG changes similar to acute coronary syndrome. Early consideration is vital due to potential severe outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Systematic Reviews
Background:
- Myocarditis following group A streptococcal pharyngitis/tonsillitis is uncommon.
- Identifying characteristic clinical and diagnostic features is crucial.
Purpose of the Study:
- To systematically review and identify specific electrocardiogram (ECG) changes, laboratory parameters, signs, and symptoms associated with post-streptococcal myocarditis.
Main Methods:
- A systematic literature review was conducted adhering to PRISMA guidelines.
- Searched multiple databases including PubMed/MEDLINE, Web of Science, and LILACS.
- Included human studies on myocarditis post-streptococcal pharyngitis/tonsillitis, excluding other myocarditis types.
Main Results:
- Patients frequently exhibit chest pain, elevated cardiac biomarkers, and ST-segment elevations.
- The presentation often mimics acute coronary syndrome more than viral myocarditis.
Conclusions:
- Post-streptococcal myocarditis is infrequently described but requires consideration in patients with streptococcal sore throat.
- This condition can lead to severe adverse events, necessitating prompt recognition.
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