Histopathological Aspects of Myocarditis with Special Reference to Mumps, Cytomegalovirus Infection and the Role of Endomyocardial Biopsy

  • U. Baandrup
  • S. A. Mortensen
Conference paper

Abstract

Myocarditis has been defined as “an inflammatory process of the heart muscle due to known or unknown causes, excluding atherosclerosis of the coronary arteries”, which may or may not be associated with inflammation elsewhere in the body” [21]. This definition is probably agreeable to most. For practical purposes, however, it is often difficult to establish morphologically whether or not certain structural changes are of an inflammatory (infectious) origin. Ischaemic heart disease must be excluded, which is not always easy or clear-cut; and what about the flabby, enlarged heart without significant cell infiltration at histological examination and for which an aetiological explanation cannot be traced? Is it caused by excessive alcohol consumption? Is it a sequel of myocarditis or the aftermath of exposition to toxic agents in the environment? What really constitutes the disease known as “dilated (congestive) cardiomyopathy”?

Keywords

Corticosteroid Influenza Luminal Cardiomyopathy Cardiol 

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References

  1. 1.
    Bengtsson E (1972) Acute myocarditis and its consequences in Sweden. Postgrad Med J 48: 754–5PubMedCrossRefGoogle Scholar
  2. 2.
    Bengtsson E, Örndahl G (1954) Complications of mumps with special reference to the incidence of myocarditis. Acta Med Scand 149: 381–8PubMedCrossRefGoogle Scholar
  3. 3.
    Brown NJ, Richmond S J (1980) Fatal mumps myocarditis in an 8-month-old child. Br Med J 281: 356–7PubMedCrossRefGoogle Scholar
  4. 4.
    Baandrup U, Olsen EGJ (1981) Critical analysis of endomyocardial biopsies from patients suspected of having myocarditis. I. Morphological and morphometric aspects. Br Heart J 45: 475–81PubMedCrossRefGoogle Scholar
  5. 5.
    Baandrup U, Florio RA, Olsen EGJ (1982) Do endomyocardial biopsies represent the morphology of the rest of the myocardium? A quantitative light microscopic study of single v. multiple biopsies with the King’s bioptome. Eur Heart J 3: 171–8PubMedGoogle Scholar
  6. 6.
    Daly K, Richardson PJ, Olsen EGJ, Pattison J, Jackson G, Jewitt DE (1981) Immunosuppresive therapy in acute inflammatory myocarditis (abstract). Circulation 64 [Suppl IV]: IV-27Google Scholar
  7. 7.
    Hugo A, Carrasio G, Palacios E, Scorza C, Rangel A, Inglessis G, Fuenmayor A (1981) Usefulness of septal endomyocardial biopsy for early diagnosis of Chagasic cardiomyopathy (abstract). Am J Cardiol 47: 401CrossRefGoogle Scholar
  8. 8.
    Hunt SA, Rider AK, Stinson EB, Griepp RB, Schroeder JS, Harrison DC, Shumway NE (1976) Does cardiac transplantation prolong life and improve its quality? Circulation 54 [Suppl.3]: 56–60Google Scholar
  9. 9.
    Johnson RA, Palacios I (1982) Dilated cardiomyopathies of the heart. N Engl J Med 307: 1051–8, 1119–26PubMedCrossRefGoogle Scholar
  10. 10.
    Konno S, Sakakibara S (1963) Intracardiac heart biopsy. Dis Chest 44: 345–50PubMedCrossRefGoogle Scholar
  11. 11.
    Krakower CA, Roberg NB (1962) Clinical pathologic conference. Am Heart J 63: 276–82PubMedCrossRefGoogle Scholar
  12. 12.
    Kussy JC (1976) Fatal mumps myocarditis. Minn Med 57: 285–6Google Scholar
  13. 13.
    Levin S (1980) Parvovirus: a possible etiologic agent in cardiomyopathy and endocardial fibroelastosis. Hum Pathol 11: 404–5PubMedCrossRefGoogle Scholar
  14. 14.
    Lowry PJ, Edwards CW, Nagle RE (1982) Herpes-like virus particles in myocardium of patient progressing to congestive cardiomyopathy. Br Heart J 48: 501–3PubMedCrossRefGoogle Scholar
  15. 15.
    MacArthur CGC, Cambridge G, Waterson AP, Goodwin JF, Oakley CM (1978) Antibodies to Coxsackie B viruses in primary congestive cardiomyopathy (abstract). Br Heart J 40: 456Google Scholar
  16. 16.
    Maisch B, Berg PA, Kochsiek K (1980) Immunological parameters in patients with congestive cardiomyopathy. Basic Res Cardiol 75: 221–2PubMedCrossRefGoogle Scholar
  17. 17.
    Manca C (1932) Miocardite da parotite epidemica. Arch Ital Anat Istol Pat 3: 707Google Scholar
  18. 18.
    Mason JW, Billingham ME, Ricci DR (1980) Treatment of acute inflammatory myocarditis assisted by endomyocardial biopsy. Am J Cardiol 45: 1037–44PubMedCrossRefGoogle Scholar
  19. 19.
    Melvin KR, Richardson PJ, Olsen EGJ, Daly K, Jackson G (1982) Peripartum cardiomyopathy due to myocarditis. N Engl J Med 307: 731–4PubMedCrossRefGoogle Scholar
  20. 20.
    Mortensen SA, Egeblad H (1983) Endomyocardial biopsy guided by two-dimensional echocardiography. Br Heart J 50: 246–51PubMedCrossRefGoogle Scholar
  21. 21.
    Olsen EGJ (1980) The pathology of the heart, 2nd edn. Macmillan, London, p 178Google Scholar
  22. 22.
    Richardson PJ (1974) King’s endomyocardial bioptome. Lancet 1: 660–1PubMedCrossRefGoogle Scholar
  23. 23.
    Roberts WC, Fox SM (1965) Mumps of the heart: clinical and pathologic features. Circulation 32: 342–5PubMedGoogle Scholar
  24. 24.
    Rosenberg DM (1945) Acute myocarditis in mumps (epidemic parotitis). Arch Intern Med 76: 257–63CrossRefGoogle Scholar
  25. 25.
    Sánchez GR, Neches WH, Jaffe R (1982) Myocardial aneurysm in association with disseminated cytomegalovirus infection. Pediatr Cardiol 2: 63–5PubMedCrossRefGoogle Scholar
  26. 26.
    Seifert G (1965) Die zytomegale Virusmyokarditis. Dtsch Med Wochenschr 90: 149–52PubMedCrossRefGoogle Scholar
  27. 27.
    Tiula E, Leinikki P (1972) Fatal cytomegalovirus infection in a previously healthy boy with myocarditis and consumption coagulopathy as presenting signs. Scand J Infect Dis 4: 57–60PubMedGoogle Scholar
  28. 28.
    Vogel FS (1958) Enhanced susceptibility of proliferating endothelium to salivary gland virus under naturally occuring and experimental conditions. Am J Pathol 34: 1069–79PubMedGoogle Scholar
  29. 29.
    Waris E, Räsänen O, Kreus K-E, Kreus R (1972) Fatal cytomegalovirus disease in a previously healthy adult. Scand J Infect Dis 4: 61–7PubMedGoogle Scholar
  30. 30.
    Weiss M, Drusin R, Fenoglio JJ Jr (1979) Chronic myocarditis and cardiomyopathy: a clinical pathological study (abstract). Circulation 59–60 [Suppl II]: 156Google Scholar
  31. 31.
    Williams AG, Habermehl KK, Kaintz RP (1982) Clinical utility of 2-D echocardiography in myocardial biopsy (abstract). Circulation 66 [Suppl II]: 8CrossRefGoogle Scholar
  32. 32.
    Wilson FM, Miranda QR, Chason JL, Lerner AM (1969) Residual pathologic changes following murine Coxsackie A and B myocarditis. Am J Pathol 55: 253–65PubMedGoogle Scholar
  33. 33.
    Wilson RSE, Morris TH, Rees JR (1972) Cytomegalovirus myocarditis. Br Heart J 34: 865–8PubMedCrossRefGoogle Scholar
  34. 34.
    Wink K, Schmitz H (1980) Cytomegalovirus myocarditis. Am Heart J 100: 667–72PubMedCrossRefGoogle Scholar
  35. 35.
    Woodruff JF (1980) Viral myocarditis. A review. Am J Pathol 101: 427–79Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1984

Authors and Affiliations

  • U. Baandrup
  • S. A. Mortensen

There are no affiliations available

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