Cocksackie B4 virus, courtesy CDC, via Wikipedia
The Cocksackie B virus is a group of six related viruses that cause illness in humans. Although in most cases the symptoms are mild and the disease passes in the normal course, it is estimated that up to 50% of sudden deaths in otherwise healthy persons are due to the virus, which can manifest as myocarditis, pericarditis or aseptic meningitis. It is a frequent differential diagnosis on the show, but no patient has been diagnosed with it.
Most persons who get the virus will only suffer a stomach ache or intestinal distress, similar to gastritis. However, the virus is highly variable. It can take from 2 days to over a month to go through its incubation period, and it can resolve itself in anywhere from two days to two weeks. However, if a patient is suffering from chest pain together with any other of the symptoms of the virus, it is likely the disease is in a dangerous stage and immediate emergency medical attention is appropriate.
The disease can be diagnosed through blood tests or blood cultures. Usually, identification of the sub-type of virus is unnecessary because treatment is the same. Unfortunately, the disease is difficult to treat and there is no well accepted protocol. Anti-inflammatory drugs are usually used to protect the heart. Otherwise, the patient should be given supportive care appropriate to the symptoms.