Dangerous kisses: Epstein-barr virus myocarditis mimicking myocardial infarction

Advancing Precision Medicine in Myocarditis: Current Status and Future Perspectives in Endomyocardial Biopsy-Based Diagnostics and Therapeutic Approaches

The diagnosis and specific and causal treatment of myocarditis and inflammatory cardiomyopathy remain a major clinical challenge. Despite the rapid development of new imaging techniques, endomyocardial biopsies remain the gold standard for accurate diagnosis of inflammatory myocardial disease. With the introduction and continued development of immunohistochemical inflammation diagnostics in combination with viral nucleic acid testing, myocarditis diagnostics have improved significantly since their introduction. Together with new technologies such as miRNA and gene expression profiling, quantification of specific immune cell markers, and determination of viral activity, diagnostic accuracy and patient prognosis will continue to improve in the future. In this review, we summarize the current knowledge on the pathogenesis and diagnosis of myocarditis and inflammatory cardiomyopathies and highlight future perspectives for more in-depth and specialized biopsy diagnostics and precision, personalized medicine approaches.

Acute myocarditis mimicking ST-elevation myocardial infarction: A case report and review of the literature

The present study describes the case of a young man aged 22 who had acute retrosternal pain, elevated cardiac markers and electrocardiographic ST-T changes, which led to an original misdiagnosis of acute myocardial infarction. The patient underwent immediate coronary angiography, which revealed normal coronary arteries. Finally, the diagnosis of viral myocarditis was made on consideration of his fever, scattered red dots on his arms and legs and other auxiliary examination results obtained in the following days, which were supportive of the diagnosis. The patient improved on antiviral and myocardial protection therapy and was discharged 2 weeks later. Viral myocarditis is a common disease with a variable natural history. It remains challenging for doctors to differentiate between acute myocarditis and myocardial infarction, particularly in the early stages. A diagnosis of myocarditis should be made on the basis of synthetic evaluation of the evidence, including medical history, clinical presentation and results of the available auxiliary tests, in order to provide guidelines for treatment.

Epstein-Barr virus myocarditis as the first symptom of infectious mononucleosis

This case report describes a 20-year-old immunocompetent man with an episode of chest pain radiating into both arms, an increase in the level of myocardial enzymes, electrocardiogram abnormalities (widespread ST-segment elevation and q waves in leads V(4)-V(6)) and serological evidence for acute Epstein-Barr Virus infection preceding typical signs and symptoms of infectious mononucleosis.