Myocarditis epidemiology: Difference between revisions
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{{Myocarditis}} | {{Myocarditis}} | ||
{{CMG}} | {{CMG}} '''Associate Editor-In-Chief:''' [[Varun Kumar]], M.B.B.S.; {{CZ}} | ||
==Overview== | ==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]]. | 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]]. | ||
==Epidemiology and Demographics== | |||
===Incidence=== | |||
In routine [[autopsy|autopsies]], 1-9% of all patients had evidence of myocardial inflammation. | |||
===Age=== | |||
In young adults, up to 20% of all cases of [[sudden death]] are due to myocarditis. | |||
===Gender=== | |||
Myocarditis is slightly more frequent among males than females. This may be due to protection conferred by the ovarian cycle.<ref name="pmid15527830">{{cite journal| author=Schwartz J, Sartini D, Huber S| title=Myocarditis susceptibility in female mice depends upon ovarian cycle phase at infection. | journal=Virology | year= 2004 | volume= 330 | issue= 1 | pages= 16-23 | pmid=15527830 | doi=10.1016/j.virol.2004.06.051 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15527830 }} </ref> | |||
== | ===Race=== | ||
No difference in frequency of myocarditis has been observed between the various races. | |||
==Etiology in Developed Countries== | ===Etiology in 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, with the Coxsackie-B viruses being the most common cause.<ref name="pmid8682098">{{cite journal| author=Friman G, Wesslén L, Fohlman J, Karjalainen J, Rolf C| title=The epidemiology of infectious myocarditis, lymphocytic myocarditis and dilated cardiomyopathy. | journal=Eur Heart J | year= 1995 | volume= 16 Suppl O | issue= | pages= 36-41 | pmid=8682098 | doi= | pmc= | url= }} </ref> Recent studies show that [[adenovirus]], [[parvovirus B19]], [[hepatitis C]], and [[herpes virus]] 6 were the common causes for myocarditis<ref name="pmid18645053">{{cite journal| author=Kindermann I, Kindermann M, Kandolf R, Klingel K, Bültmann B, Müller T et al.| title=Predictors of outcome in patients with suspected myocarditis. | journal=Circulation | year= 2008 | volume= 118 | issue= 6 | pages= 639-48 | pmid=18645053 | doi=10.1161/CIRCULATIONAHA.108.769489 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18645053 }} </ref><ref name="pmid15699250">{{cite journal| author=Kühl U, Pauschinger M, Noutsias M, Seeberg B, Bock T, Lassner D et al.| title=High prevalence of viral genomes and multiple viral infections in the myocardium of adults with "idiopathic" left ventricular dysfunction. | journal=Circulation | year= 2005 | volume= 111 | issue= 7 | pages= 887-93 | pmid=15699250 | doi=10.1161/01.CIR.0000155616.07901.35 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15699250 }} </ref>. | 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, with the Coxsackie-B viruses being the most common cause.<ref name="pmid8682098">{{cite journal| author=Friman G, Wesslén L, Fohlman J, Karjalainen J, Rolf C| title=The epidemiology of infectious myocarditis, lymphocytic myocarditis and dilated cardiomyopathy. | journal=Eur Heart J | year= 1995 | volume= 16 Suppl O | issue= | pages= 36-41 | pmid=8682098 | doi= | pmc= | url= }} </ref> Recent studies show that [[adenovirus]], [[parvovirus B19]], [[hepatitis C]], and [[herpes virus]] 6 were the common causes for myocarditis<ref name="pmid18645053">{{cite journal| author=Kindermann I, Kindermann M, Kandolf R, Klingel K, Bültmann B, Müller T et al.| title=Predictors of outcome in patients with suspected myocarditis. | journal=Circulation | year= 2008 | volume= 118 | issue= 6 | pages= 639-48 | pmid=18645053 | doi=10.1161/CIRCULATIONAHA.108.769489 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18645053 }} </ref><ref name="pmid15699250">{{cite journal| author=Kühl U, Pauschinger M, Noutsias M, Seeberg B, Bock T, Lassner D et al.| title=High prevalence of viral genomes and multiple viral infections in the myocardium of adults with "idiopathic" left ventricular dysfunction. | journal=Circulation | year= 2005 | volume= 111 | issue= 7 | pages= 887-93 | pmid=15699250 | doi=10.1161/01.CIR.0000155616.07901.35 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15699250 }} </ref>. | ||
Myocarditis secondary to [[lyme disease]] should be suspected in people traveling to regions where it is endemic, particularly if there are associated conduction abnormalities of the heart.<ref name="pmid2644885">{{cite journal| author=McAlister HF, Klementowicz PT, Andrews C, Fisher JD, Feld M, Furman S| title=Lyme carditis: an important cause of reversible heart block. | journal=Ann Intern Med | year= 1989 | volume= 110 | issue= 5 | pages= 339-45 | pmid=2644885 | doi= | pmc= | url= }} </ref> | Myocarditis secondary to [[lyme disease]] should be suspected in people traveling to regions where it is endemic, particularly if there are associated conduction abnormalities of the heart.<ref name="pmid2644885">{{cite journal| author=McAlister HF, Klementowicz PT, Andrews C, Fisher JD, Feld M, Furman S| title=Lyme carditis: an important cause of reversible heart block. | journal=Ann Intern Med | year= 1989 | volume= 110 | issue= 5 | pages= 339-45 | pmid=2644885 | doi= | pmc= | url= }} </ref> | ||
==Etiology in Developing Countries== | ===Etiology in 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]]<ref name="pmid16253886">{{cite journal| author=Carapetis JR, Steer AC, Mulholland EK, Weber M| title=The global burden of group A streptococcal diseases. | journal=Lancet Infect Dis | year= 2005 | volume= 5 | issue= 11 | pages= 685-94 | pmid=16253886 | doi=10.1016/S1473-3099(05)70267-X | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16253886 }} </ref> and [[HIV infection]]. | In South America, [[Chagas' disease]] (caused by ''[[Trypanosoma cruzi]]'') is the main cause of myocarditis. Other causes in developing countries include [[rheumatic fever]]<ref name="pmid16253886">{{cite journal| author=Carapetis JR, Steer AC, Mulholland EK, Weber M| title=The global burden of group A streptococcal diseases. | journal=Lancet Infect Dis | year= 2005 | volume= 5 | issue= 11 | pages= 685-94 | pmid=16253886 | doi=10.1016/S1473-3099(05)70267-X | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16253886 }} </ref> and [[HIV infection]]. | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Cardiology]] | |||
[[Category:Cardiovascular diseases]] | |||
[[Category:Inflammations]] | |||
[[Category:Emergency medicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Up-To-Date cardiology]] | |||
[[Category:Signs and symptoms]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Revision as of 17:05, 10 January 2013
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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.
Epidemiology and Demographics
Incidence
In routine autopsies, 1-9% of all patients had evidence of myocardial inflammation.
Age
In young adults, up to 20% of all cases of sudden death are due to myocarditis.
Gender
Myocarditis is slightly more frequent among males than females. This may be due to protection conferred by the ovarian cycle.[1]
Race
No difference in frequency of myocarditis has been observed between the various races.
Etiology in 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, with the Coxsackie-B viruses being the most common cause.[2] Recent studies show that adenovirus, parvovirus B19, hepatitis C, and herpes virus 6 were the common causes for myocarditis[3][4].
Myocarditis secondary to lyme disease should be suspected in people traveling to regions where it is endemic, particularly if there are associated conduction abnormalities of the heart.[5]
Etiology in 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[6] and HIV infection.
References
- ↑ 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.
- ↑ 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.