Acute interstitial myocarditis

Abstract

A case is reported in which the clinical picture simulated that seen in coronary occlusion, but the pathological findings were those of acute interstitial myocarditis. In a brief review of the literature the following points stand out: 1. 1. The diagnosis is necessarily a pathological one, since there is no uniform clinical picture. 2. 2. While sudden death sometimes occurs, in the majority of cases death is preceded by symptoms of progressive myocardial failure of variable duration. 3. 3. Although there is no known etiology, the frequent association with infections, especially pyogenic infections of the skin, is suggestive. 4. 4. Analysis of the pathological findings in thirty cases reveals the fact that the microscopic picture is the one constant finding. 5. 5. In the majority of the cases there are also cardiac hypertrophy and dilatation, a greyish-yellow mottling of the myocardium of the left or both ventricles, and acute congestion of the viscera. 6. 6. In most of the cases of more than one month's duration there are mural thrombi in the left ventricle.