Retrospective study of patients admitted to the cardiology intensive care unit of a university hospital between January 2009 and March 2014 with a discharge diagnosis of myocarditis. Patients with suspected acute coronary syndrome (ACS) underwent either coronary angiography or coronary computed tomography angiography (CCTA). Clinical follow-up was obtained by phone call to the referring physician.
During the study period, 84 patients (mean age 37±14 years old, 83% males) were admitted for myocarditis. 54% of admissions occurred between November and February. A chest pain was present in 93% of Pts and 35.7% of Pts had fever in the preceding month. In 38.1% of Pts, ECG was suggestive of ACS whereas diffuse ST elevation was found in 26.2% of Pts and a normal ECG in 23.8%. A pericardial effusion was found in 31.3% of Pts. Mean ejection fraction was 59.6±8.8%. Peak Troponin was 657±704ng/l. CRP was increased in 75.3%. A cardiac MRI was performed in 90.5% of cases and a coronary angiography in 47.6% of cases. No endomyocardial biopsy was performed. An infectious aetiology was found in 47.6% of cases. Treatment included aspirin (87.5%), beta-blockers (66.5%), and ACE inhibitors (42.9%). There was no death during hospital stay. At a mean follow-up of 28±20 months, 2 Pts (2.6%) died from non-cardiac causes and recurrences occurred in only 5.3% of Pts. Mean ejection fraction was 62.1±5.3%.
Patients admitted in a cardiology intensive care unit for acute myocarditis are mostly young males and a large part of admissions occurs during winter. In-hospital and mid-term outcome is good.