Title:Viral Heart Disease and Acute Coronary Syndromes - Often or Rare Coexistence?
Volume: 24
Issue: 4
Author(s): Agnieszka Pawlak*, Natalia Wiligorska, Diana Wiligorska, Malgorzata Frontczak–Baniewicz, Maciej Przybylski, Rafal Krzyzewski, Andrzej Ziemba and Robert J. Gil
Affiliation:
- Mossakowski Medical Research Centre, Academy of Science, Warsaw,Poland
Keywords:
Viral infection, coronary artery disease, diagnosis, treatment, atherosclerotic plaque, endomyocardial biopsy.
Abstract: Background: Clinical presentation of viral myocarditis can mimic acute coronary syndrome and making
diagnosis of viral heart disease (VHD) may be challenging. The presence of coronary artery disease (CAD)
does not always exclude VHD and these entities can coexist. However, the incidence of co-occurrence of CAD
and VHD is not precisely known. Moreover, inflammatory process caused by viruses may result in atherosclerotic
plaque destabilization.
Methods: The goal of this work is to summarize the current knowledge about co-occurrence of VHD and CAD.
This article presents the importance of inflammatory process in both diseases and helps to understand pathophysiological
mechanisms underlying their coexistence. It provides information about making differential diagnosis
between these entities, including clinical presentation, noninvasive imaging features and findings in endomyocardial
biopsy. Although currently there are no standard therapy strategies in coexistence of VHD and CAD, we
present some remarkable aspects of treatment of patients, in whom VHD co-occurs with CAD.
Results: Viral heart disease may occur both in patients without and with atherosclerotic plaques in coronary arteries.
Destabilization of atherosclerotic plaques in coronary arteries can be facilitated by inflammatory process.
Increased inflammatory infiltrates in the coronary lesions of patients with VHD can lead to plaques’ instability
and consequently trigger acute coronary syndrome.
Conclusion: In this article we attempted to present that co-occurrence of VHD and CAD may have therapeutic
implications and as specific antiviral treatment is currently available, proper diagnosis and treatment can improve
patient’s condition and prognosis.
