Acute myocarditis is a disorder that can cause a fulminant illness resulting in severe functional impairment or death. Myocarditis appears to be a precursor to dilated cardiomyopathy in some patients.
A. Causes
Acute myocarditis has been associated with infection by Coxsackie B3 and B5, mumps, Epstein-Barr, and influenza as well as other viruses. In approximately 50% of patients with HIV who developed dilated cardiomyopathy, asso¬ciated myocarditis was observed on biopsy. In more than 50% of HIV patients myocarditis was observed at autopsy. HIV or cytomegalovirus appears to be the cause of myo¬carditis in patients with AIDS.
Chagas disease is the most common cause of myocardi¬tis in Latin America and is caused by toxoplasmosis and diphtheria. Acute myocarditis is associated with lupus erythematosus and Kawasaki syndrome. Forms of giant cell infiltration of the myocardium may occur with Sjogren’s syndrome, giant cell arteritis, thymoma, myasthenia gravis, chronic active hepatitis, and ulcerative colitis. Patients with giant cell myocarditis appear to have a prognosis worse than that of lymphocytic myocarditis. Hypersensi-tivity to drugs and other exogenous agents may also cause myocarditis.

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