Myocardial involvement in infectious hepatitis.

A WIDE variety of infectious diseases may affect the heart giving rise to myocarditis. During life the diagnosis often depends upon the recognition of the possibilities of myocarditis in the particular infection. Viruses, bacteria and parasites have all been incriminated as a cause of this disorder. There have been very few reports in the literature on infectious hepatitis causing myocarditis. This paper presents four cases of myocarditis due to infectious hepatitis. They have been described in detail in another communication (Nagaratnam, Gunawardena & De Silva, 1971). Only the myocardial aspects are described here. Case reports Case 1 RAS (28155), a male, aged 51 years, was admitted on 28 October, 1970, with a history of jaundice of 20 days' duration. He took alcohol occasionally. On admission, he complained of some discomfort in his chest. Examination revealed a deeply jaundiced individual. His blood pressure was 130/80 mmHg. There were no bruits or additional heart sounds. The lungs were clear. The liver was enlarged two fingerbreadths below the right costal margin. There was ascites and slight oedema of the legs. The results of the liver function tests are shown in Table 1. An electrocardiogram showed low T waves in II, inversion of the T waves in III, aVF, V1-V6 on 28 October, 1970 (Fig. 1) and 4 days later showed upright T waves. Comment. The clinical and biochemical findings were those of infectious hepatitis. Clinically there were no signs related to the cardiovascular system.