Abstract
Acute myopericarditis is a major cause of acquired heart disease worldwide in pediatric patients. Various viruses have been reported as the etiology, of which varicella zoster virus was first reported in 1953. However, since nationwide administration of the varicella vaccine, reports of varicella-associated myopericaridits have become sporadic. We report a case of varicella myopericarditis with an initial manifestation of chest pain, tachycardia, and hypotension. Typical skin vesicles developed 2 days after these symptoms, which confirmed the diagnosis. Intravenous immunoglobulin was administered before the appearance of the skin vesicles under the impression of suspected Coxsackie virus infection. Intravenous acyclovir effectively controlled the progression of the disease, and both clinical symptoms and electrocardiographic changes subsided soon after the use of an antiviral agent. Varicella zoster virus serum IgM antibody also showed positive test results. On the following visit, the patient’s myocardial function had fully recovered from this episode.
References
Bullowa JGM, Wishik SM (1935) Complications of varicella: their occurrence among 2534 patients. Am J Dis Child 49:923–926
Jackson MA, Burry VF, Olson LC (1992) Complications of varicella requiring hospitalization in previously healthy children. Pediatr Infect Dis J 11:441–445
Shekerdemian L, Bohn D (2006) Acute viral myocarditis: epidemiology and pathophysiology. Pediatr Crit Care Med 7:S2–S7
Imazio M, Cecchi E, Demichelis B, Chinaglia A, Ierna S, Demarie D, Ghisio A, Pomari F, Belli R, Trinchero R (2008) Myopericarditis versus viral or idiopathic acute pericarditis. Heart 94:498–501
Abrams D, Derrick G, Penny DJ, Shinebourne EA, Redington AN (2001) Cardiac complications in children following infection with varicella zoster virus. Cardiol Young 11:647–652
Imazio M, Trinchero R (2008) Myopericarditis: etiology, management, and prognosis. Int J Cardiol 127:17–26
Pinamonti B, Alberti E, Cigalotto A, Dreas L, Salvi A, Silvestri F, Camerini F (1988) Echocardiographic findings in myocarditis. Am J Cardiol 62:285–291
Robinson JL, Hartling L, Crumley E, Vandermeer B, Klassen TP (2005) A systematic review of intravenous gamma globulin for therapy of acute myocarditis. BMC Cardiovasc Disord 5:12
Khatib R, Reyes MP, Smith FE (1990) Enhancement of Coxsackie virus B3 replication in Vero cells by indomethacin. J Infect Dis 162:997–998
Waagner DC, Murphy TV (1990) Varicella myocarditis. Pediatr Infect Dis J 9:360–363
Rich R, McErlean M (1993) Complete heart block in a child with varicella. Am J Emerg Med 11:602–605
Tsintsof A, Delprado WJ, Keogh AM (1993) Varicella zoster myocarditis progressing to cardiomyopathy and cardiac transplantation. Br Heart J 70:93–95
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Kao, KL., Yeh, SJ. & Chen, CC. Myopericarditis Associated with Varicella Zoster Virus Infection. Pediatr Cardiol 31, 703–706 (2010). https://doi.org/10.1007/s00246-009-9637-5
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DOI: https://doi.org/10.1007/s00246-009-9637-5