Myocarditis epidemiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.; Cafer Zorkun, M.D., Ph.D. [2]
Overview
In developed countries, myocarditis is generally due to viral infections such as coxsackie B, enterovirus,adenovirus, parvovirus B19, hepatitis C, and herpes virus 6. In developing countries, myocarditis is generally due to HIV and rheumatic heart disease.
Developed countries
Viral infections are the most common cause of myocarditis in developed countries. Common viral causes include coxsackie B and enterovirus. The frequency of dilated cardiomyopathy secondary to myocarditis 7.5-10% per 100,000 annually with enteroviruses, and particularly the Coxsackie-B viruses being the most common cause[1]. Recent studies show that adenovirus, parvovirus B19, hepatitis C, and herpes virus 6 were the common causes for myocarditis[2][3].
The exact incidence of myocarditis is unknown. However, in series of routine autopsies, 1-9% of all patients had evidence of myocardial inflammation. In young adults, up to 20% of all cases of sudden death are due to myocarditis.
Myocarditis secondary to lyme disease should be suspected in people travelling to regions where it is endemic, particularly if they have conduction abnormalities of heart[4].
Developing countries
In South America, Chagas' disease (caused by Trypanosoma cruzi) is the main cause of myocarditis. Other causes in developing countries include rheumatic fever[5] and HIV infection.
Race
No difference in frequency of myocarditis has been observed between the various races.
The impact of Gender
Myocarditis is slightly more frequent among males than in females[6]. This may be due to natural hormonal protection among females.
References
- ↑ Friman G, Wesslén L, Fohlman J, Karjalainen J, Rolf C (1995). "The epidemiology of infectious myocarditis, lymphocytic myocarditis and dilated cardiomyopathy". Eur Heart J. 16 Suppl O: 36–41. PMID 8682098.
- ↑ Kindermann I, Kindermann M, Kandolf R, Klingel K, Bültmann B, Müller T; et al. (2008). "Predictors of outcome in patients with suspected myocarditis". Circulation. 118 (6): 639–48. doi:10.1161/CIRCULATIONAHA.108.769489. PMID 18645053.
- ↑ Kühl U, Pauschinger M, Noutsias M, Seeberg B, Bock T, Lassner D; et al. (2005). "High prevalence of viral genomes and multiple viral infections in the myocardium of adults with "idiopathic" left ventricular dysfunction". Circulation. 111 (7): 887–93. doi:10.1161/01.CIR.0000155616.07901.35. PMID 15699250.
- ↑ McAlister HF, Klementowicz PT, Andrews C, Fisher JD, Feld M, Furman S (1989). "Lyme carditis: an important cause of reversible heart block". Ann Intern Med. 110 (5): 339–45. PMID 2644885.
- ↑ Carapetis JR, Steer AC, Mulholland EK, Weber M (2005). "The global burden of group A streptococcal diseases". Lancet Infect Dis. 5 (11): 685–94. doi:10.1016/S1473-3099(05)70267-X. PMID 16253886.
- ↑ Schwartz J, Sartini D, Huber S (2004). "Myocarditis susceptibility in female mice depends upon ovarian cycle phase at infection". Virology. 330 (1): 16–23. doi:10.1016/j.virol.2004.06.051. PMID 15527830.