REVIEW article

Front. Cardiovasc. Med.

Sec. General Cardiovascular Medicine

Informative Title: Cardiovascular Complications in Chronic Active Epstein-Barr Virus Infection: A Narrative Review

  • 1. Department of Ultrasound, Mianyang Central Hospital, Mianyang, China

  • 2. Department of Hematology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China

The final, formatted version of the article will be published soon.

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Summary

Keywords

Cardiogram, cardiovascular complication, chronic active Epstein-Barr virus, Coronary artery lesions, pulmonary arterial hypertension

Received

04 July 2025

Accepted

18 February 2026

Copyright

© 2026 Xu, Wei and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Lin Shi

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