HYPERSENSITIVITY—A COMMON DENOMINATOR IN MYOCARDIAL DISEASE?

Abstract

With increasing wonder, cardiologists suspect that knowledge of the fundamentals of allergy is desirable for the proper understanding of myocardial disease. Striking similarity in disease states characterized by pericarditis and myocarditis suggest a common pathogenesis. Rheumatic fever, idiopathic pericarditis, the postcommissurotomy syndrome (postpericardiotomy syndrome) and the postmyocardial infarction syndrome are acute or recurrent inflammatory diseases associated with polyserositis and pleural pericardial pain. It is quite possible that hypersensitivity is a contributory or even a basic mechanism in each instance. The immunological response is related to streptococcal antigens in rheumatic fever, to necrosis in the postmyocardial infarction syndrome, to surgical trauma in the postcommissurotomy syndrome, and to viral antigens in idiopathic pericarditis. Acute benign idiopathic pericarditis offers a particularly fruitful disease for the evaluation of immunological factors. Is idiopathic pericarditis a simple virus infection? There are ever increasing numbers of reports of pericarditis occurring in the acute phase of Coxsackie virus