Mcheik Batoul, Ayach Hassan B, El Koubayati Georgio, Abdallah Rim M, Khalil Majd, Jammal Mouin, Haddad Fady, Abi Rached Naji
Internal Medicine, Lebanese University Faculty of Medicine, Beirut, LBN.
Cardiology, Lebanese University Faculty of Medicine, Beirut, LBN.
Cureus. 2024 May 24;16(5):e60990. doi: 10.7759/cureus.60990. eCollection 2024 May.
Myocarditis is an inflammatory disease of the cardiac muscle that manifests as chest pain, dyspnea, and other signs of heart failure. ST segment changes with elevated cardiac biomarkers mimic acute coronary syndromes. It is most commonly caused by viruses like the Epstein-Barr virus (EBV) and Coxsackie B virus, but it can also be due to cardiotoxic drugs like cyclophosphamide and cocaine or caused by a systemic infiltrative process like sarcoidosis or collagen vascular diseases. One relatively common bacterial cause of myocarditis is beta-hemolytic Group A , which is well known to lead, two to three weeks later, to rheumatic fever and pancarditis. Less commonly, it can cause non-rheumatic myocarditis, which occurs faster, with the pathogenesis not very well understood. We will be reporting a case series of two brothers suffering at the same time from non-rheumatic streptococcal A-isolated myocarditis, questioning the possibility of bacterial toxin-mediated myocarditis or inter-linked genetic predisposition.
心肌炎是一种心肌的炎症性疾病，表现为胸痛、呼吸困难及其他心力衰竭症状。ST段改变伴心肌生物标志物升高类似于急性冠状动脉综合征。其最常见的病因是病毒，如EB病毒（EBV）和柯萨奇B病毒，但也可能由环磷酰胺和可卡因等心脏毒性药物引起，或由结节病或胶原血管病等全身性浸润性疾病导致。心肌炎相对常见的一种细菌病因是A组β溶血性链球菌，众所周知，它在两到三周后会导致风湿热和全心炎。较少见的情况下，它可引起非风湿性心肌炎，发病更快，其发病机制尚不太清楚。我们将报告一个病例系列，两名兄弟同时患有非风湿性A组链球菌分离性心肌炎，质疑细菌毒素介导的心肌炎或相互关联的遗传易感性的可能性。
