Asunto(s)
Angioplastia Coronaria con Balón , Procedimientos Quirúrgicos Cardíacos/normas , Puente de Arteria Coronaria/normas , Enfermedad Coronaria/cirugía , Adulto , Anciano , Angioplastia Coronaria con Balón/normas , Procedimientos Quirúrgicos Cardíacos/estadística & datos numéricos , Puente de Arteria Coronaria/estadística & datos numéricos , Enfermedad Coronaria/diagnóstico , Enfermedad Coronaria/tratamiento farmacológico , Femenino , Hospitales de Condado/normas , Hospitales de Condado/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Prospectivos , Garantía de la Calidad de Atención de Salud , Encuestas y Cuestionarios , SueciaRESUMEN
In a prospective study, 57 patients with a preliminary diagnosis of myocarditis were investigated. Twenty-four patients were considered to have an acute myocarditis, 14 had a suspected myocarditis, while in 19 patients myocarditis was excluded. Episodes of frequent supraventricular and/or ventricular extrasystoles during hospital stay were seen in 8/24 cases (33%) with myocarditis and in 1/19 cases (5%) without myocarditis. On follow-up 1 month later, no supraventricular extrasystoles were observed in either group. Echocardiographic signs consistent with left ventricular insufficiency were noted in 7/24 cases (29%) with myocarditis, in 1/14 cases (7%) with suspected myocarditis and in no case without myocarditis. With a "routine" serologic test battery covering influenza viruses A and B, adenovirus, Coxsackie virus group B, ECHO viruses, Chlamydia psittaci, Mycoplasma pneumoniae and hemolytic streptococci group A, a possible etiology could be documented in 9/24 cases (38%) with myocarditis and in 4/19 cases (21%) without myocarditis. Enterovirus-specific IgM was detected with solid-phase reverse immunosorbent test (SPRIST) in 12/23 (48%) cases with myocarditis and in 3/16 cases (19%) without myocarditis. In SPRIST-IgM-positive cases, IgM antibodies were detected in 15/20 (75%) of the sera taken on admission. The overall serological results indicated a recent infection in 16/24 cases (67%) with myocarditis and in 5/19 cases (26%) without myocarditis (p less than 0.05).