acute myocarditis

Question 1

define

Answer 1

= acute inflammation + necrosis of cardiac muscle

Question 2

causes

Answer 2

usually idiopathic

viral- coxsackie B = commonest in uk, HIV/EBV/CMV

bacterial- post strep, TB, diptheria, syphillis

fungal- candidiasis

protozoal- trypanosomiasis[chagas disease] = common in south africa

drugs- cyclophosphamide, herceptin, carbamazepine

autimmune- giant cell myocarditis associated w/ SLE

others- cocaine abuse, heavy metals radiation

Question 3

s/s

Answer 3

flu like prodrome: fever, sore throat, myalgia

dyspnoea

fatigue

sharp chest pain [suggeting associated pericarditis]

arrhythmias- palpies

soft S1

S4- gallop

Question 4

ix

Answer 4

bloods: positive trop, high CK

ecg:

• st elevation
• t wave inversion
• transient AV block

Question 5

mx

Answer 5

is dependent on the underlying cause. In many it is only asymptomatic.

In patients with connective tissue disease steroid therapy is indicated eg prednisolone 40mg/d.