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European Heart Journal 1984 5(12):1023-1035;
Copyright © 1984 by the European Society of Cardiology.
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© 1984 The European Society of Cardiology

The relationship of myocarditis to dilated cardiomyopathy

C. G. C. MACARTHUR*, D. TARIN{dagger},, J. F. GOODWIN{ddagger} and K. A. HALLIDIE-SMTTH{ddagger}

*Department of Medicine, Prince Henry Hospital Little Bay, Sydney, NSW 2036, Australia
{dagger}Nuffield Department of Pathology (University of Oxford), John Radcliffe Hospital Oxford 0X3 9DU, U.K.,
{ddagger}Department of Medicine (Clinical Cardiology), Royal Postgraduate Medical School, Hammersmith Hospital London W12 OHS, U.K.

Received 13 August 1984; revised 4 October 1984; .

Address for correspondence: Dr D. Tarin, Nuffield Department of Pathology (University of Oxford), John Radcliffe Hospital, Oxford OX3 9DU, UK

Abstract

Three patients with congestive cardiomyopathy are reported in whom high neutralizing antibody titres to Coxsackie B viruses were detected. At post-mortem examination, all three had histologically demonstrable chronic inflammation of the myocardium. The hearts of ten patients dying in cardiac failure due to other causes showed no comparable inflammatory infiltration. This provides further evidence that Coxsackie B viral myocarditis is involved in the pathogenesis of some cases of dilated cardiomyopathy.

One patient also had pulmonary veno-occlusive disease. This has been reported in association with myocarditis once previously in an infant. A viral aetiology has been postulated. It seems likely in this patient to have also been due to a Coxsackie B virus.

Key Words: Dilated cardiomyopathy • myocarditis • Coxsackie B viruses


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