Miocardite por vírus Epstein Barr: Relato de Caso

Myocarditis is inflammation of the heart muscle which can be caused by infectious diseases (especially virus), systemic diseases, drugs and toxins. The main involved virus in the development of this disease is the coxsackie type B. Objective: The objective of this paper is describe a case of acute myocarditis by Epstein Barr virus, its presentation, propedeutic and evolution. Methods: Analysis of medical records and literature review. Case description: Male patient, 19 years, with an atypical chest pain and no history of heart disease, denied use of illicit drugs. He reported recurrent tonsillitis, the last one was two weeks ago. denied fever. Physical examination at admission revealed no significant changes. Electrocardiogram (ECG) initially showed early ventricular repolarization and twenty-four hours later ST segment elevation and T wave inversion at V3 to V6. Biochemical markers of myocardial injury at high levels, with CK-MB curve. Doppler echocardiogram showed mild systolic dysfunction of the left ventricle (LV) due to diffuse hypokinesia and thickened pericardium without effusion. Serology for Epstein Barr Virus (EBV) IgG and IgM were reactive, anti-HBs 788 IU / L. Cardiac magnetic resonance imaging (MRI) showed preserved global LV function, presence of delayed enhancement of a heterogeneous pattern in mesocardium at the inferior and lateral segments, sparing the endocardium, consistent with necrosis / fibrosis secondary to non-ischemic injury (myocarditis). Conclusion: Myocarditis should always be considered in cases of typical or atypical chest pain in a patient without previous cardiac history, with history of recent viral infection