From the Guidelines
Yes, adenovirus can cause both pericarditis and myocarditis. Adenoviruses are common viral pathogens that typically cause respiratory, gastrointestinal, or conjunctival infections, but they can also affect the heart in some cases. When adenovirus infects the heart tissue, it can trigger inflammation of the pericardium (pericarditis) or the heart muscle itself (myocarditis) 1. This occurs through direct viral invasion of cardiac cells and the subsequent immune response. The clinical presentation may include:
- Chest pain
- Shortness of breath
- Fatigue
- Palpitations
- Fever
Diagnosis typically involves a combination of clinical symptoms, cardiac biomarkers (like troponin), electrocardiogram changes, and imaging studies such as echocardiography or cardiac MRI 1. Treatment is generally supportive, focusing on managing symptoms with anti-inflammatory medications like NSAIDs or colchicine for pericarditis, while severe cases of myocarditis may require hospitalization for cardiac monitoring 1. Most adenovirus-induced cardiac inflammation resolves without long-term complications, though severe cases can lead to heart failure or arrhythmias requiring additional treatment. According to the most recent guidelines, hospitalization is recommended for patients with definite myocarditis that is either mild or moderate in severity, ideally at an advanced heart failure center 1.
From the Research
Adenovirus and Pericarditis/Myocarditis
- Adenovirus can cause pericarditis, as reported in a case study where a 2-year-old patient was diagnosed with pericarditis caused by adenovirus infection 2.
- Adenovirus infection can also cause myocarditis, as evidenced by a study that reported eight children dying from cardiogenic shock due to myocarditis, with adenovirus genome detected in 75% of the cases 3.
- Pericarditis and myocarditis can be caused by various viral infections, including adenovirus, enteroviruses, influenza viruses, and parvovirus B19 3.
- Treatment for pericarditis typically involves anti-inflammatory therapy, such as aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), and colchicine, with corticosteroids used in specific cases 4, 5, 6.
Diagnosis and Treatment
- Metagenomics next-generation sequencing (mNGS) can be used to diagnose rare adenovirus myocarditis in children 2.
- Polymerase chain reaction (PCR) assay can be used to detect adenovirus nucleic acid in blood and pericardial effusion 2.
- Treatment for acute pericarditis typically involves a combination of NSAIDs, aspirin, and colchicine, with the goal of reducing symptoms and preventing recurrence 4, 5, 6.
- Colchicine monotherapy may be a viable option for preventing recurrent pericarditis in patients with heart failure with reduced ejection fraction and/or coronary artery disease, although further study is needed 6.