Myocarditis

Question 1

What occurs in myocarditis? What are the possible causes of this?

Answer 1

Inflammation of the myocardium

Viral infection or AI

Question 2

How might someone with myocarditis typically present?

Answer 2

Chest pain 
Palpitations- manifestation of arrhythmia 
Fever 
Flu-like symptoms 
SOB
Signs of HF= oedematous 

Tends to be male and in 4/5th decade of life

Question 3

What investigations would you do and what might you expect to find if myocarditis was suspected?

Answer 3

ECG= T wave inversions, ST depression/elevation 
FBC= raised WCC
CRP/ESR= raised 
Troponin= raised 
Serology to identify cause
Endomyocardial biopsy= gold standard

Question 4

How would you manage someone with myocarditis?

Answer 4

Treat the cause-> supportive treatment for viral infection

Treat the cardiac failure (occurs as complication)

Question 5

What is the most common cause of myocarditis world wide? What are the associated complications and how do you management these patients?

Answer 5

Chagas disease (kissing bugs i.e. triatomine bug which rubs faeces into bite wound)

Complications:

• megaoesophagus
• megacolon -> chronic constipation
• myocarditis-> cardiomyopathy and HF