Myocarditis masquerading cardiovascular disorders: A case series

Abstract

Myocarditis is defined as an inflammatory infiltration of the myocardium with associated necrosis or degeneration, or both. The disease is also known as inflammatory cardiomyopathy, with various aetiologies contributing to its onset. Among these, viral infections have garnered substantial attention due to their potential to trigger myocardial inflammation and lead to severe cardiac complications. Post-viral myocarditis, a subset of myocarditis, occurs as a consequence of viral infections and represents a critical intersection between infectious diseases and cardiology. Viruses such as enteroviruses, adenoviruses, and more recently, SARS-CoV-2, have been implicated in post-viral myocarditis, underlining the broad spectrum of viral triggers that clinicians must consider. Myocarditis presents in various forms, including Fulminant myocarditis (17%), which can lead to complete resolution or severe cardiac compromise resulting in rapid deterioration and death; Acute myocarditis (65%) typically causes moderate cardiovascular compromise and incomplete recovery with the potential for cardiac dysfunction or subsequent death; Chronic active myocarditis (11%) resembles acute myocarditis but tends to progress to mild or moderate cardiac dysfunction, often with restrictive physiology, and exhibits ongoing fibrosis on histologic examination; and Chronic persistent myocarditis (7%) characterized by non-resolving active or borderline inflammatory infiltrates on histologic examination, typically without cardiovascular compromise.