Myocarditis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S.
Myocarditis is inflammation of myocardium resulting in cardiac dysfunction and arrhythmais. Using animal models, Liu PP and Mason JW explained that myocarditis is a continuum of 3 distinct disease processes with one evolving into the other[1]:
- Phase I: Viral infection and replication
- Viruses such as coxsackie and enterovirus, gets internalized in peripheral tissues and initiate immune system activation. Few of these viral genomes harbor on to the immunologic cells which circulate throughout the body and are thus seeded to other target organs such as heart where they further replicate and cause tissue destruction.
- Phase II: Autoimmune injury
- Host immune system eliminates the viral genomes from the body and promote recovery. However, sometimes immune system remain active even after elimination of virus. This leads to development of autoimmune reaction where the T-cells and the cytokines targets the host tissue which causes further myocyte damages.
- Phase III: Dilated cardiomyopathy