Tsintsof A, Delprado W J, Keogh A M
Cardiopulmonary Transplant Unit, St Vincent's Hospital, Darlinghurst, Sydney, Australia.
Br Heart J. 1993 Jul;70(1):93-5. doi: 10.1136/hrt.70.1.93.
The case of a 12 year old schoolgirl with heart failure due to varicella myocarditis is reported. Heart failure and cardiogenic shock were evident 21 days after the appearance of the rash, and cardiac transplantation was performed two weeks later. Myocarditis is a serious complication of varicella zoster infection and heart failure may be fulminant. Endomyocardial biopsy changes consistent with myocarditis were documented six days after the start of heart failure. The histological changes, however, developed into those of idiopathic dilated cardiomyopathy (with anisonucleosis and fibre width variation) over a seven day period. This case provides further evidence for the link between viral myocarditis and idiopathic cardiomyopathy and underlines the value of immediate endomyocardial biopsy in heart failure of recent onset. Cardiac transplantation led to a rapid and full recovery.
报告了一名12岁因水痘性心肌炎导致心力衰竭的女学生病例。皮疹出现21天后出现心力衰竭和心源性休克，两周后进行了心脏移植。心肌炎是水痘带状疱疹感染的严重并发症，心力衰竭可能是暴发性的。心力衰竭开始六天后记录到与心肌炎一致的心内膜活检变化。然而，组织学变化在七天内发展为特发性扩张型心肌病（有核仁大小不均和纤维宽度变化）。该病例为病毒性心肌炎与特发性心肌病之间的联系提供了进一步证据，并强调了对近期发生的心力衰竭立即进行心内膜活检的价值。心脏移植导致快速且完全康复。
