# Cardiovascular complications in chronic active Epstein-Barr virus infection: a narrative review

## TL;DR

This review summarizes the rare but severe cardiovascular complications of chronic active Epstein-Barr virus infection, highlighting differences between children and adults.

## Contribution

The paper provides a comprehensive summary of clinical features and management strategies for CAEBV-related cardiovascular complications.

## Key findings

- Cardiovascular complications in CAEBV include coronary artery lesions, arrhythmias, and pulmonary arterial hypertension.
- Children more commonly present with coronary artery lesions and electrocardiographic abnormalities, while adults show more heart failure and pulmonary hypertension.
- Systematic cardiovascular evaluation is crucial for timely intervention and long-term monitoring in CAEBV patients.

## Abstract

Cardiovascular involvement in chronic active Epstein–Barr virus (CAEBV) infection represents an uncommon yet severe spectrum of complications, including coronary artery lesions, arrhythmias, and pulmonary arterial hypertension. Reliable large-scale data for the management of CAEBV-associated cardiovascular damage are currently lacking. In this literature review, we aimed to summarize the clinical characteristics, pathological features, diagnostic approaches, and treatment strategies for CAEBV-related cardiac damage. This summary may enhance the awareness of CAEBV-associated cardiovascular complications and provide valuable insights for their clinical management. In this narrative review, we aimed to summarize the clinical characteristics, pathological features, diagnostic approaches, and treatment strategies for CAEBV-related cardiac damage.

PubMed, Embase, Web of Science, CNKI, CQVIP, and Wanfang Data databases were searched as part of this narrative review to collect data on CAEBV infection with cardiovascular involvement and to summarize its characteristics, pathological features, diagnostic approaches, and treatment strategies.

We identified 32 articles reporting CAEBV-associated cardiovascular complications involving 57 patients with a median age of 11 years (range: 1–69 years). Among these patients, 19 (33.3%) were adults and 38 (66.7%) were children; 24 (42.1%) were male and 33 (57.9%) were female. Coronary artery lesions, electrocardiographic abnormalities, valvular regurgitation, and pericardial lesions were more frequent in children, whereas heart failure and pulmonary arterial hypertension were more prevalent in adults.

Cardiovascular involvement in CAEBV infection is rare and presents substantial diagnostic and therapeutic challenges. The systematic evaluation of cardiovascular involvement is crucial for timely intervention and long-term surveillance. The poor prognosis of CAEBV-associated cardiovascular complications underscores the urgent need for further research to elucidate its pathogenic mechanisms and optimize therapeutic strategies.