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Anales de Pediatria Nov 2022
Topics: Humans; Myocarditis; Coxsackievirus Infections; Antiviral Agents
PubMed: 35995700
DOI: 10.1016/j.anpede.2022.01.006 -
QJM : Monthly Journal of the... Oct 2022
Topics: Humans; COVID-19 Vaccines; Myocarditis; COVID-19; SARS-CoV-2
PubMed: 34791457
DOI: 10.1093/qjmed/hcab281 -
Current Cardiology Reports Aug 2021In coronavirus disease 2019 (COVID-19), myocardial injury occurs frequently in severe or critically ill hospitalized patients, yet myocarditis is much less common. In... (Review)
Review
PURPOSE OF REVIEW
In coronavirus disease 2019 (COVID-19), myocardial injury occurs frequently in severe or critically ill hospitalized patients, yet myocarditis is much less common. In this context, revisiting the definition of myocarditis is appropriate with a specific focus on diagnostic and management considerations in patients infected with SARS-CoV-2.
RECENT FINDINGS
Pathologic cardiac specimens from patients with COVID-19 suggest a mixed inflammatory response involving lymphocytes and macrophages, and importantly, cellular injury occurs predominantly at the level of pericytes and endothelial cells, less often involving direct myocyte necrosis. In COVID-19, the diagnosis of myocarditis has understandably been based predominantly on clinical criteria, and the number of patients with clinically suspected myocarditis who would meet diagnostic histological criteria is unclear. Echocardiography and cardiac magnetic resonance are important diagnostic tools, although the prognostic implications of abnormalities are still being defined. Importantly, SARS-CoV2 myocarditis should be diagnosed within an appropriate clinical context and should not be based on isolated imaging findings. Therapies in COVID-19 have focused on the major clinical manifestation of pneumonia, but the promotion of viral clearance early in the disease could prevent the development of myocarditis, and further study of immunosuppressive therapies once myocarditis has developed are indicated. A strict and uniform approach is needed to diagnose myocarditis due to SARS-CoV-2 to better understand the natural history of this disease and to facilitate evaluation of potential therapeutic interventions. A methodological approach will also better inform the incidence of COVID-19 associated myocarditis and potential long-term health effects.
Topics: COVID-19; Endothelial Cells; Humans; Incidence; Myocarditis; Prognosis; RNA, Viral; SARS-CoV-2
PubMed: 34342728
DOI: 10.1007/s11886-021-01551-x -
Drug Safety Sep 2023Immune checkpoint inhibitors (ICIs) have revolutionized the treatment and care of patients with cancer owing to unique features, including the occurrence of the... (Review)
Review
Immune checkpoint inhibitors (ICIs) have revolutionized the treatment and care of patients with cancer owing to unique features, including the occurrence of the so-called immune-related adverse events (irAEs). A multidisciplinary team, possibly including a cardio-oncology specialist, is warranted to achieve a favorable patient outcome. Cardiovascular toxicity, especially myocarditis, emerged as a life-threatening irAE in the real-word setting, and the European Society of Cardiology has recently published the first guideline on cardio-oncology to increase awareness and promote a standardized approach to tackle this complex multimodal issue, including diagnostic challenges, assessment, treatment, and surveillance of patients with cancer receiving ICIs. In this article, through a question & answer format made up of case vignettes, we offer a clinically oriented overview on the latest advancements of ICI-related cardiovascular toxicity, focusing on myocarditis and associated irAEs (myositis and myasthenia gravis within the so-called overlap syndrome), with the purpose of assisting clinicians and healthcare professionals in daily clinical practice.
Topics: Humans; Immune Checkpoint Inhibitors; Antineoplastic Agents, Immunological; Myocarditis; Neoplasms; Medical Oncology
PubMed: 37341925
DOI: 10.1007/s40264-023-01320-5 -
Tidsskrift For Den Norske Laegeforening... Dec 2022Immunological checkpoint inhibitors have been revolutionary in the treatment of cancer. A rare but serious adverse effect is the development of heart muscle inflammation...
Immunological checkpoint inhibitors have been revolutionary in the treatment of cancer. A rare but serious adverse effect is the development of heart muscle inflammation (myocarditis). The prevalence of this type of myocarditis is increasing as more cancer patients receive treatment with immune checkpoint inhibitors. Knowledge of immune checkpoint inhibitor-induced myocarditis is important to enable early diagnosis and initiation of treatment. In this article we provide a clinical review of this.
Topics: Humans; Myocarditis; Myocardium; Neoplasms; Drug-Related Side Effects and Adverse Reactions
PubMed: 36511752
DOI: 10.4045/tidsskr.21.0817 -
Annales de Cardiologie Et D'angeiologie Dec 2020The outbreak of the SARS-CoV-2 virus responsible for the COVID-19 disease has given rise to a new disease whose boundaries are still to be discovered. While the first... (Review)
Review
The outbreak of the SARS-CoV-2 virus responsible for the COVID-19 disease has given rise to a new disease whose boundaries are still to be discovered. While the first data suggested a purely respiratory infection, the most recent publications highlight a large pleomorphism of the disease, responsible for multiple organ damage, of which cardiac injury seems to be the most represented. This cardiac injury can present as acute myocarditis. Our aim was to discuss the pathophysiological rationale underlying the existence of SARS-CoV-2 myocarditis and to analyze the literature data regarding the diagnosis and treatment of this particular entity.
Topics: COVID-19; Humans; Myocarditis
PubMed: 33069383
DOI: 10.1016/j.ancard.2020.10.001 -
Cardiology 2022Recent surveillance studies following nationwide mass vaccination are investigating rare complications such as myocarditis, pericarditis, and thromboembolic events... (Review)
Review
BACKGROUND
Recent surveillance studies following nationwide mass vaccination are investigating rare complications such as myocarditis, pericarditis, and thromboembolic events related to mRNA-based Covid-19 vaccines.
SUMMARY
In the current report, we present an overview of the incidence, clinical presentation and management of post-mRNA vaccine myocarditis, and pericarditis in view of the currently available data. Our main focus is directed toward myocarditis.
KEY MESSAGES
Myocarditis following mRNA-based Covid-19 vaccines is rare, more frequently affects younger men <30 years and is usually of mild severity with spontaneous recovery. The overall benefit of mRNA vaccines in terms of protecting from severe Covid-19 infection and associated cardiovascular complications outweighs the risk of postvaccination myocarditis. Currently, there are no dedicated guidelines for patients with postvaccination myocarditis or pericarditis in terms of the frequency of follow-up including clinical assessment, repeated echocardiography, and cardiac resonance imaging. However, follow-up studies in terms of long-term consequences are underway.
Topics: Humans; Male; COVID-19; COVID-19 Vaccines; Incidence; mRNA Vaccines; Myocarditis; Pericarditis; RNA, Messenger; Vaccines, Synthetic
PubMed: 35104821
DOI: 10.1159/000522216 -
Methodist DeBakey Cardiovascular Journal 2021Coronavirus disease 2019 (COVID-19) is a global pandemic that, at the time of this writing, has led to 178,000,000 cases worldwide and more than 3,875,000 deaths.... (Review)
Review
Coronavirus disease 2019 (COVID-19) is a global pandemic that, at the time of this writing, has led to 178,000,000 cases worldwide and more than 3,875,000 deaths. Cardiovascular complications of COVID-19 have become the focus of investigation after many hospitalized COVID-19 patients-with or without established cardiovascular disease-incurred clinical or subclinical myocardial injury, including isolated biomarker elevations, myocardial infarction, arrhythmia, heart failure, myocarditis, and cardiogenic shock. In this review, we highlight the most recent evidence of the prevalence and potential etiologies of acute and subclinical myocardial injury in COVID-19 patients.
Topics: Arrhythmias, Cardiac; COVID-19; Humans; Myocarditis; Pandemics; SARS-CoV-2
PubMed: 34992721
DOI: 10.14797/mdcvj.1038 -
Current Opinion in Anaesthesiology Feb 2022Cardiovascular involvement in coronavirus disease 2019 (COVID-19) is relatively common and portends an increased risk of morbidity and mortality. Manifestations of... (Review)
Review
PURPOSE OF REVIEW
Cardiovascular involvement in coronavirus disease 2019 (COVID-19) is relatively common and portends an increased risk of morbidity and mortality. Manifestations of myocardial injury may exhibit significant overlap and result in diagnostic uncertainty. This review will summarize recent literature around cardiovascular complications of COVID-19.
RECENT FINDINGS
Venous thromboembolism, atrial fibrillation, and type II myocardial infarction are observed commonly in COVID-19, while severe acute respiratory syndrome coronavirus 2 viral myocarditis remains quite rare. Although infrequent, COVID-19 vaccination has been associated with myocarditis and pericarditis in young individuals.
SUMMARY
Various forms of COVID-19-related myocardial injury have been associated with increased utilization of mechanical ventilation, hemodynamic deterioration, and mortality. Manifestations of myocardial injury in COVID-19 are varied, but share common drivers of illness including sequelae of sepsis, immune-mediated factors, and a prothrombotic state. Understanding the forms of myocardial injury in COVID-19 may aid in rapid diagnosis and treatment.
Topics: COVID-19; COVID-19 Vaccines; Cardiovascular Diseases; Humans; Myocarditis; SARS-CoV-2
PubMed: 34839301
DOI: 10.1097/ACO.0000000000001076 -
Trends in Cardiovascular Medicine Apr 2022An early report during the SARS-CoV-2 (COVID-19) outbreak noted myocardial involvement with cardiac troponin I (cTnI) levels >99 percentile in approximately 20% of... (Review)
Review
An early report during the SARS-CoV-2 (COVID-19) outbreak noted myocardial involvement with cardiac troponin I (cTnI) levels >99 percentile in approximately 20% of hospitalized patients. Patients with cTnI elevations had higher in-hospital mortality. Additionally, myocarditis is associated with exercise-related sudden cardiac death in athletes. Therefore, reports of COVID-19 myocarditis concerned the sports cardiology community, which issued two guidelines on managing athletes with COVID-19 infection. We reviewed reports of myocardial involvement in athletes after COVID-19 infection published before June 2021. The incidence of the diagnosis of myocarditis in athletes post-COVID-19 ranged from 0 to 15.4% based on cardiac magnetic resonance imaging (cMRI) performed 10 to 194 days after initial diagnosis of COVID-19. Only a few studies adhered to accepted myocarditis diagnostic guidelines and only two studies included a control group of uninfected athletes. There was significant heterogeneity in the method and protocols used in evaluating athletes post-COVID-19. The incidence of COVID-19 myocarditis in athletes appears to be over-diagnosed. The evaluation of myocarditis post-COVID-19 should be individually performed and managed according to the current guidelines. This can potentially prevent needless training restrictions and the inability to participate in competitive sports.
Topics: Athletes; COVID-19; Humans; Incidence; Magnetic Resonance Imaging; Myocarditis; SARS-CoV-2
PubMed: 34954013
DOI: 10.1016/j.tcm.2021.12.009