The role of viruses in the production of heart disease

Abstract

Clinical and experimental evidence for the role of viruses in the production of heart disease in man is reviewed. The data indicate that viral myocarditis, viral endocarditis, viral pericarditis and viral pancarditis are true entities that must be considered by clinicians in diagnosis and treatment of patients. It is suggested that viruses may be involved in the production of chronic heart disease and that “conditioning” factors possibly including streptococcal infections are important, both in the original infection and in activation of latent or dormant viruses. Viral infections may be responsible for much heart muscle disease, that is, cardiomyopathy, as well as for “rheumatic heart disease” of undetermined origin. The role of viruses, particularly rubella and Coxsackie, in the production of congenital heart disease is emphasized. Conceivably, viral infection acquired in utero might produce heart disease later in life. Many viruses are known to cause clinical pericarditis, some followed by chronic constriction. A possible role of viruses in the production of the postpericardiotomy syndrome or cardiac causalgia is suggested. Measures for the prevention of viral heart disease and methods of treatment, with particular emphasis on prolonged bed rest, are discussed. The need for laboratory facilities for routine viral studies is stressed.