Myocarditis Flashcards
What is myocarditis?
An inflammatory disease of the myocardium.
It is sometimes concurrent with inflammation of the pericardium, in which case it is referred to as myopericarditis.
What are the clinical features of myocarditis?
Signs and symptoms are broad.
Cardiac-type chest pain, fatigue, palpitations, and symptoms of heart failure.
Myocarditis can in some cases present with sudden unexplained cardiac death.
Examination findings are non-specific. Signs of heart failure may be evident (along with S3 and S4 gallops). If pericarditis is associated, auscultation can reveal a pericardial friction rub.
ECG changes
Non-specific ST segment and T wave changes
Ectopic beats
Arrhythmias if present
Tachycardia
Troponin levels
Markedly elevated
Echocardiogram results
Ventricular dysfunction in the form of diastolic dysfunction or regional wall motion abnormalities.
Cardiac MRI
Cardiac MRI findings can help confirm the diagnosis of myocarditis by showing the presence and extent of inflammation.
What is the gold standard investigation?
Biopsy via cardiac catheterisation but is associated with its own risks as it is an invasive test.
Management
Treatment involves addressing the underlying cause alongside supportive management.
ITU support may be required as patients may require vasopressors.
Corticosteroids are sometimes considered in a select group of patients with viral myocarditis.
After recovery, patients should be advised to limit activity for a few months.
Who is myocarditis seen in?
Myocarditis is one of the most common causes of chest pain in young patients.
What can myocarditis be a complication of?
It may complicate viral or bacterial infections, e.g. Coxsackie B virus, diphtheria.
What is the most common viral cause of myocarditis?
Coxsackievirus B
