Left ventricular function in acute inflammatory peri-myocardial diseases – new insights and long-term follow-up

We report on 100 patients with acute perimyocarditis admitted during 2008–2011, in whom LV function was assessed by semi-quantitative wall motion score analysis on conventional echo. Long-term mortality and recurrent hospitalization were also assessed.Wall motion score in 100 patients with acute perimyocarditis demonstrated a significant predominance of regional wall motion abnormalities in the infero-postero-lateral LV wall. These data correspond well with speckle tracking results of a subgroup of these patients published earlier. Recent MRI data show frequent late enhancement of contrast in the infero-lateral region of the LV in patients with perimyocarditis. These observations were useful in re-classification of our patients into one of the following groups: pure or predominant pericarditis, and pure or predominant myocarditis. Over a mean period of 37 months, there was no mortality. Though recurrent hospitalizations were rather frequent, no significant differences were observed among groups.Regional wall motion abnormalities in the infero-postero-lateral segments of the LV are frequent in patients with acute perimyocarditis. Detailed echocardiographic examination early in the course of the disease should become a major factor in the clinical differentiation among the various clinical presentations of acute inflammatory peri-myocardial syndromes. The long-term outcome of these patients appears to be benign, though recurrent hospitalizations are not infrequent.The clinical spectrum of acute inflammatory peri-myocardial syndromes is diverse. Diagnostic features include typical clinical presentation with chest pain aggravating with inspirium and supine position and ameliorating while sitting, often in the setting of a recent viral infection. Additional features include typical electrocardiographic changes, positive inflammatory markers and elevated cardiac enzymes (troponin (Tn). Conventional echo examination may identify pericardial involvement/effusion and myocard