{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T06:37:26Z","timestamp":1781332646464,"version":"3.54.1"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":2102,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T00:00:00Z","timestamp":1584489600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Project ERA-CVD","award":["JTC 2016 IKDT-IGCM"],"award-info":[{"award-number":["JTC 2016 IKDT-IGCM"]}]},{"name":"Italian Ministry of Health"},{"name":"European Project ERA-CVD","award":["JTC 2016 IKDT-IGCM"],"award-info":[{"award-number":["JTC 2016 IKDT-IGCM"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Myocardial infection by Epstein\u2013Barr virus (EBV) may manifest with inflammatory cardiomyopathy, coronary syndrome X, and rarely with infarct-like myocarditis. The aim of the report is to describe a case of myocardial EBV infection causing acute myocarditis with heart failure, necrotizing coronary vasculitis, and multiple left ventricular (LV) aneurysms. A 67-year-old woman presented with fever, chest pain, and heart failure. She underwent non-invasive cardiac studies including electrocardiography, 2D-echocardiography, cardiac magnetic resonance, hematochemical exams with Troponin T determination, and invasive studies including cardiac catheterization, coronary angiography, and LV endomyocardial biopsy. Five endomyocardial samples were processed for histology and immunohistochemistry for inflammatory cells characterization and detection of viral antigens. Two additional frozen samples were evaluated by real-time polymerase chain reaction for the presence of cardiotropic viral genomes. Routine laboratory tests revealed the presence of elevated white blood cells (17 000 103\/\u03bcL) and increased Troponin T. Electrocardiogram showed sinus tachycardia with ST elevation in V2\u2013V5. Two-dimensional echocardiography showed normal LV dimension with reduced LV contractility (LVEF = 40%) with mild pericardial effusion. Cardiac magnetic resonance revealed the presence of a micro-aneurism in the inferior LV wall, a diffuse oedematous imbibition of LV myocardium suggested by hyper-intensity of T2 mapping, and increased fibrosis as suggested by areas of late gadolinium enhancement signals. Coronary arteries were normal while several micro-aneurysms were observed at LV angiography. At histology, a lymphocytic myocarditis with necrotizing coronary vasculitis sustained by a positive real-time polymerase chain reaction for EBV, detectable in cardiomyocytes and inflamed intramural vessels by positive immunohistochemistry for EBV latent membrane protein 1 antigen, was observed. Myocardial EBV infection is an unusual cause of acute heart failure and cardiac aneurysms, increasing the risk of electrical instability, cardiac perforation, and sudden death.<\/jats:p>","DOI":"10.1002\/ehf2.12611","type":"journal-article","created":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T17:48:36Z","timestamp":1584553716000},"page":"938-941","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Infarct-Like Myocarditis with Coronary Vasculitis and Aneurysm Formation Caused by Epstein\u2013Barr virus Infection"],"prefix":"10.1093","volume":"7","author":[{"given":"Cristina","family":"Chimenti","sequence":"first","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, La Sapienza University , Viale del Policlinico 155, Rome, 00161 ,","place":["Italy"]},{"name":"Cellular and Molecular Cardiology Lab, IRCCS L. Spallanzani , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romina","family":"Verardo","sequence":"additional","affiliation":[{"name":"Cellular and Molecular Cardiology Lab, IRCCS L. Spallanzani , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Grande","sequence":"additional","affiliation":[{"name":"Cellular and Molecular Cardiology Lab, IRCCS L. 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Spallanzani , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,3,18]]},"reference":[{"key":"2026012115044614400_ehf212611-bib-0001","doi-asserted-by":"crossref","first-page":"3534","DOI":"10.1161\/01.CIR.0000148823.08092.0E","article-title":"Intramyocyte detection of Epstein-Barr virus genome by laser capture microdissection in patients with inflammatory cardiomyopathy","volume":"7","author":"Chimenti","year":"2004","journal-title":"Circulation"},{"key":"2026012115044614400_ehf212611-bib-0002","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1136\/hrt.2010.196626","article-title":"High prevalence of intramural coronary infection in patients with drug-resistant cardiac syndrome X: comparison with chronic stable angina and normal controls","volume":"96","author":"Chimenti","year":"2010","journal-title":"Heart"},{"key":"2026012115044614400_ehf212611-bib-0003","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1097\/00007611-198909000-00033","article-title":"Acute Epstein-Barr virus myocarditis simulating myocardial infarction with cardiogenic shock","volume":"82","author":"Tyson","year":"1989","journal-title":"South Med J"},{"key":"2026012115044614400_ehf212611-bib-0004","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3389\/fped.2019.00219","article-title":"Chronic active Epstein-Barr virus infection with systemic vasculitis and pulmonary arterial hypertension in a child","volume":"7","author":"Ba","year":"2019","journal-title":"Front Pediatr"},{"key":"2026012115044614400_ehf212611-bib-0005","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.repc.2012.04.010","article-title":"Fulminant myocarditis-case report","volume":"31","author":"Faria","year":"2012","journal-title":"Rev Port Cardiol"},{"key":"2026012115044614400_ehf212611-bib-0006","doi-asserted-by":"crossref","first-page":"119","DOI":"10.2169\/internalmedicine.50.4143","article-title":"Pulmonary arterial hypertension associated with chronic active Epstein-Barr virus infection","volume":"50","author":"Hashimoto","year":"2011","journal-title":"Intern Med"},{"key":"2026012115044614400_ehf212611-bib-0007","doi-asserted-by":"crossref","first-page":"104","DOI":"10.4103\/0975-2870.167969","article-title":"Unusual infectious mononucleosis complicated by vasculitis","volume":"9","author":"Sahu","year":"2016","journal-title":"Medical Journal of Dr DY Patil University Case Report"},{"key":"2026012115044614400_ehf212611-bib-0008","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4172\/2161-0703.1000193","article-title":"A rare case of acute myocarditis","volume":"4","author":"Sarvari","year":"2015","journal-title":"J Med Microb Diagn"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fehf2.12611","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.12611","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.12611","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/7\/3\/938\/65805012\/eschf_7_3_938.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/7\/3\/938\/65805012\/eschf_7_3_938.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T20:05:47Z","timestamp":1769025947000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/7\/3\/938\/8373078"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,18]]},"references-count":8,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,3,18]]},"published-print":{"date-parts":[[2020,6,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.12611","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,6]]},"published":{"date-parts":[[2020,3,18]]},"assertion":[{"value":"2019-08-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}