Korean J Intern Med.  2012 Jun;27(2):216-220. 10.3904/kjim.2012.27.2.216.

Acute Viral Myopericarditis Presenting as a Transient Effusive-Constrictive Pericarditis Caused by Coinfection with Coxsackieviruses A4 and B3

• Lee WS
• Lee KJ
• Kwon JE
• Oh MS
• Kim JE
• Cho EJ
• Kim CJ

• KMID: 1776550
• DOI: http://doi.org/10.3904/kjim.2012.27.2.216

Abstract

Acute myopericarditis is usually caused by viral infections, and the most common cause of viral myopericarditis is coxsackieviruses. Diagnosis of myopericarditis is made based on clinical manifestations of myocardial (such as myocardial dysfunction and elevated serum cardiac enzyme levels) and pericardial (such as inflammatory pericardial effusion) involvement. Although endomyocardial biopsy is the gold standard for the confirmation of viral infection, serologic tests can be helpful. Conservative management is the mainstay of treatment in acute myopericarditis. We report here a case of a 24-year-old man with acute myopericarditis who presented with transient effusive-constrictive pericarditis. Echocardiography showed transient pericardial effusion with constrictive physiology and global regional wall motion abnormalities of the left ventricle. The patient also had an elevated serum troponin I level. A computed tomogram of the chest showed pericardial and pleural effusion, which resolved after 2 weeks of supportive treatment. Serologic testing revealed coxsackievirus A4 and B3 coinfection. The patient received conservative medical treatment, including nonsteroidal anti-inflammatory drugs, and he recovered completely with no complications.

Keyword

Myocarditis; Pericarditis, constrictive; Coxsackievirus infection

MeSH Terms

Acute Disease
*Coinfection
Coxsackievirus Infections/complications/diagnosis/therapy/*virology
Echocardiography, Doppler
Electrocardiography
Enterovirus A, Human/*isolation & purification
Enterovirus B, Human/*isolation & purification
Humans
Male
Myocarditis/diagnosis/therapy/*virology
Pericardial Effusion/diagnosis/therapy/*virology
Pericarditis, Constrictive/diagnosis/therapy/*virology
Pleural Effusion/diagnosis/therapy/*virology
Tomography, X-Ray Computed
Treatment Outcome
Young Adult