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Q: viral myocarditis ?
asked by: vls6984 on August 27th, 2008
New User
My son is 14 years old and has had what he calls "Mini Heart attacks". He feels heart palpatations and gets dizzy. This has happened a couple of times last year (minus the dizziness) usually during football. This year he has had it more frequently with dizziness. So my ex-husband took him to the doctor and found a irregular heartbeat on ECG. He wore a holter monitor for 24 hours and had several episodes of tachycardia (up to 228 b/m) and 1607 irregular beats. I don't know if they were PVCs or PACs.

My son has had strep throat at least one time every year since he was born. One doctor has told me that he might be a "carrier" of the strep virus. When he was 4 months old he had herpengenia (SP). His last bought of strep was in February of this year.

I was reserching if this might have caused his irregular heart beat. I found that Strep throat could cause viral myocarditis. What I need to know is what is the prognosis for viral mycocarditis? I know that he will probably need a echo to see what his ejection fraction is and if his heart has damage. I do not believe that he has a current viral infection, so this is not an acute case. I would like to know what interventions, drugs, or therapies are available to get my son back to normal? He also still has his tonsils , and I heard that they could be a source of recurrent strep infections. Does he need to get his tonsils removed to decrease they chances of further infections?

How many children each year are diagnosed with viral myocarditis caused by strep throat? There are so many children passing strep around school and before this I have never heard of this causing heart problems, I feel very guilty that I might have decreased his chances of this, If I had only known. I have heard of rheumatic fever causing heart problems but you hardly hear of rheumatic fever anymore. I am a healthcare professional and was wondering if there was anything I could have done to prevent this? I am not even sure if this is his diagnosis, but I wanted to ask.

Thank You
Vicki
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Dr. Nikola
replied on September 5th, 2008
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"Strep throat" is a bacterial throat infection caused by the bacterium species "Streptococcus pyogenes" so it can't cause viral myocarditis. Herpangina is a viral throat infection caused by the virus Coxsackivirus and it can cause viral myocarditis.

Streptococcus pyogenes and other bacterial species from the family "Streptococcus" can cause bacterial endocarditis. In case of bacterial endocarditis the bacteria directly damage the heart's inner layer especialy the valves.

Streptococcus pyogenes can also triger an autoimmune disorder called rheumatic fiver that can affect all the heart structures including the heart muscle (myocarditis). In case of rheumatic fiver, bacteria do not damage the heart directly. There is a deffect in the immune system that causes production of antibodies and immune cells against the heart structures whenever the body gets infected by the bacterium Streptococcus pyogenes. This immune deffect is geneticaly conditioned. Geneticaly vulnerable people get attack of rheumatic fiver whenever they get infected with Streptococcus pyogenes which is one of the most common bacterial infection in the population. Rheumatic fiver attack can cause accute heart failure and even death if affects the heart musscle (rheumatic myocarditis). But disease usually damages the valves and with every new infection (and cosequently rheumatic fiver attack) the valves' become more and more damaged. This leads to chronic heart failure. The only way you can prevent rheumatic fiver attack is to prevent the infection by Streptococcus pyogenes which can be acheived by receiving depo antibiotic (usualy penicillin) every month.

You have to consult a cardiologist to diagnose your son's heart condition precisely.
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