Complete atrioventricular block associated with regional myocardial scarring in a patient with Coxsackie B2 myocarditis.

Transient atrioventricular (A-V) conduction abnormalities are often experienced in patients with evolving acute viral myocarditis, but persistent complete A-V block requiring permanent cardiac pacing is rare. We describe a case who developed irreversible complete A-V block during the long-term course of Coxsackie B2 myocarditis. The endomyocardial biopsy revealed inflammatory cellular infiltrates and myocyte necrosis. A left ventriculogram and echocardiogram consistently demonstrated an aneurysm in the basal portion of the interventricular septum. It was speculated that the extensive myocardial scar caused by acute myocarditis resulted in the ventricular aneurysm of this particular myocardial region involving the A-V conduction system.

[1]  R. Beekman,et al.  Heart block with viral myocarditis. , 1986, The Journal of pediatrics.

[2]  D. Atkins,et al.  Pacemaker management for acute onset of heart block in childhood. , 1985, The Journal of pediatrics.

[3]  J. Seward,et al.  Acute myocarditis associated with transient marked myocardial thickening and complete atrioventricular block , 1984, Clinical cardiology.

[4]  A. Matsumori,et al.  Electrocardiographic findings in experimental myocarditis in DBA/2 mice: complete atrioventricular block in the acute stage, low voltage of the QRS complex in the subacute stage and arrhythmias in the chronic stage. , 1984, Journal of the American College of Cardiology.

[5]  Y. Yokota,et al.  A long-term follow-up study of acute viral and idiopathic myocarditis. , 1983, Japanese circulation journal.

[6]  S. Rahimtoola,et al.  Left ventricular asynergy in acute myocarditis. Simulation of acute myocardial infarction. , 1983, JAMA.

[7]  A. Matsumori,et al.  Electrocardiographic abnormalities in Syrian golden hamsters with coxsackievirus B1 myocarditis. , 1982, Japanese circulation journal.

[8]  M. Hiroe,et al.  Long-term follow-up of electrocardiographic findings in patients with acute myocarditis proven by endomyocardial biopsy. , 1982, Japanese circulation journal.

[9]  A. Matsumori,et al.  2) ELECTROCARDIOGRAPHIC FINDINGS IN EXPERIMENTAL MYOCARDITIS : a) ENCEPHALOMYOCARDITIS VIRUS MYOCARDITIS IN MICE b) COXSACKIE B_1 VIRUS MYOCARDITIS IN GOLDEN HAMSTERS , 1982 .

[10]  M. Arita,et al.  Complete heart block in mumps myocarditis. , 1981, British heart journal.

[11]  Y. Hamashima,et al.  Idiopathic acute myocarditis with complete atrioventricular block in a baby. Clinicopathological study of the atrioventricular conduction system. , 1981, Japanese heart journal.

[12]  A. Benchimol,et al.  Coxsackie B5 heart disease. Demonstration of inferolateral wall myocardial necrosis. , 1980, The American journal of medicine.

[13]  K. Desser,et al.  Demonstration of Inferolateral Wall Myocardial Necrosis , 1980 .

[14]  R. Schieken,et al.  Complete heart block in viral myocarditis. , 1975, The Journal of pediatrics.

[15]  B. Okuwobi.  Multiple ventricular aneurysms. , 1975, The American journal of cardiology.

[16]  B. Chia,et al.  Stokes-Adams attacks due to acute nonspecific myocarditis. , 1975, American heart journal.

[17]  L. Gould,et al.  Complete heart block in myocarditis--recovery with a pacemaker. , 1972, Chest.

[18]  J. L. Johnson,et al.  Complete atrioventricular heart block secondary to acute myocarditis requiring intracardiac pacing. , 1971, Jornal de Pediatria.

[19]  W. Smith.  Coxsackie B myopericarditis in adults. , 1970, American heart journal.

[20]  G. Voigt.  Steroid therapy in viral myocarditis , 1968 .

[21]  T. Tlusty.  IDIOPATHIC MYOCARDITIS INVOLVING THE BUNDLE OF HIS , 1959, British heart journal.