Myocarditis - clinical course and 2-year outcome in 32 patients.

BACKGROUND: Acute myocarditis is one of the most challenging diagnoses in cardiology. It is a disease with variable clinical presentation, progression and outcome. AIM: To assess clinical characteristics and outcome of patients hospitalised with diagnosis of acute myocarditis from year 2006 to 2008. METHODS: We analysed hospital files of consecutive 32 patients admitted to our hospital due to myocarditis. All demographic, clinical and laboratory data were analysed and compared between patients with acute or subacute myocarditis. After discharge the patients were followed for 8-24 months. RESULTS: The majority of patients were males (84%) in a mean age of 33 years. Clinical and echocardiographic parameters improved in 25 (78%) of patients during hospital stay. During follow-up decreased left ventricular ejection fraction (LVEF) was observed more often in patients with subacute than acute myocarditis (mean LVEF values of 49 vs. 61%, respectively). Patients with a subacute form of the disease more frequently required chronic pharmacological therapy and more often retired from occupational activities. CONCLUSIONS: Diagnosis of myocarditis is still challenging. Careful history taking, serial laboratory, ECG and echocardiographic examinations are helpful in therapeutic decisions making and assessing prognosis. Patient with subacute myocarditis are more symptomatic than patients with acute myocarditis.

[Radiotherapy and chemotherapy for oncological diseases--unappreciated risk factors for coronary artery disease? Acute coronary syndrome in 3 women after radiotherapy and chemotherapy--case reports]. / Przebyta terapia onkologiczna--niedoceniany czynnik ryzyka choroby wiencowej? Opis trzech przypadków ostrego zespolu wiencowego u kobiet po przebytej radio- i chemioterapii.

Chest irradiation and chemotherapy may lead to precocious coronary artery disease due to accelerated atherosclerosis or fibrointimal hyperplasia. Three cases of women (43, 50, and 53 years old) without typical risk factors for cardiac disease admitted to hospital due to acute coronary syndrome are described. Two of them had received chest irradiation and chemotherapy for Hodgkin's disease in the past and the third had been treated with chemotherapy for breast cancer. They underwent emergency coronary angiography myocardial revascularisation with success (PCI treatment and CABG). Continued longitudinal screening of patients exposed to radiation and chemotherapy is needed to provide the best cardiology care.

[Left coronary artery embolism resulting from ineffective anticoagulation in a patient suffering from dilated cardiomyopathy as a possible cause of myocardial infarction--a case report]. / Zator lewej tetnicy wiencowej w przebiegu nieskutecznej terapii acenokumarolem prawdopodobna przyczyna zawalu serca u pacjenta z kardiomiopatia rozstrzeniowa.

We present a case of a 58-year-old male being treated for dilated cardiomyopathy and atrial fibrillation for more than ten years who was admitted to the intensive care unit with the diagnosis of acute ST-segment elevation myocardial infarction (STEMI). In course of further diagnostics the coronary artery embolism resulting from the unintentional anticoagulant drug (acenocumarol) dose reduction was established as the most probable cause of STEMI. Primary percutaneous coronary intervention was successfully performed and the patient was discharged home in good clinical condition.