The following chapter is one of a series of chapters in the volume entitled Infections of the Myocardium appearing in Frontiers in Bioscience. The full table of contents can be found at http://www.bioscience.org/current/special/tanowitz.htm. In this chapter, we review several parasitic infections involving the myocardium and pericardium. The most widely studied parasitic infection affecting the heart is Chagas' disease or American trypanosomiasis. In this chapter we describe issues relating to Chagas' disease not covered in detail in other chapters. African trypanosomiasis may also cause a myocarditis. The protozoan parasite, Entamoeba histolytica rarely causes a pericarditis while Toxoplasma gondii may cause myocarditis, usually in immunocompromised hosts. The larval forms of the tapeworms Echinococcus and Taenia solium may cause space-occupying lesions of the heart. Severe infection with the nematode Trichinella spiralis may cause myocarditis.

Parasitic diseases of the heart.

The objective of this study was to apply transthoracic Doppler echocardiography (TTDE) in mice to study coronary flow reserve (CFR), an index of coronary microvascular function, in mild and severe ...

Coronary flow reserve and heart failure in experimental coxsackievirus myocarditis. A transthoracic Doppler echocardiography study.

Chagas' disease caused by infection with Trypanosoma cruzi leads to a myocardiopathy that evolves from the acute to the chronic phase. Magnetic resonance imaging (MRI) is an important tool for monitoring cardiac morphology and function both in humans and in animals. In the present work, we present a brief review of MRI applications for the study of ventricular hypertrophy and dilatation of the right ventricle in murine models of Chagas' disease. Studies using MRI demonstrate an increase in right ventricular chamber dimension during both phases of infection, indicating that increase of the right ventricle is a marker for experimental chagasic myocardiopathy. Based on previous studies using MRI in these models we propose that this technique is an excellent approach for monitoring heart functionality from the acute through the chronic phase of infection in different parasite-host pairs and for monitoring the efficacy of cardioprotective or immune-therapeutic agents.

Magnetic resonance imaging in experimental Chagas disease: a brief review of the utility of the method for monitoring right ventricular chamber dilatation

The diagnosis of acute viral myocarditis should be based on a high index of suspicion, attention to historical clues, and a thorough physical exam. These should be augmented by the use of chest radiograph, electrocardiography, echocardiography, and the endomyocardial biopsy. Options. Additional evidence of the diagnosis of acute viral myocarditis may be obtained by measurements of cardiac troponin and the use of cardiovascular magnetic resonance imaging.

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Acute viral myocarditis: Diagnosis

Brief report: Recognition of acute myocarditis masquerading as acute myocardial infarction

Acute myocarditis can be caused by a variety of organisms. Congestive heart failure and death may occur as a consequence of these infections. In recent years cardiac imaging, by echocardiography and magnetic resonance and nuclear imaging has become a useful adjunct in the diagnosis and management of infectious myocarditis. Specific examples of their usefulness will be given in the discussions of chagasic myocarditis, bacterial myocarditis, acquired immunodeficiency syndrome and peripartum cardiomyopathy. Finally, we explore the exciting area of cardiac imaging of small animals, such as mice infected with Trypanosoma cruzi.

Arzu Ilercil

Papers

Cardiovascular imaging in clinical and experimental acute infectious myocarditis.