Myocarditis Flashcards
What is the most common cause of myocarditis?
Viral infections:
- Enteroviruses especially Coxsackievirus B
- HHV-6
- Parvovirus B19
- Influenza A
- HIV
What bacterial infections can cause myocarditis?
1) Rheumatic fever (GAS)
2) Chagas disease (Trypanosoma cruzi - parasite)
3) Diptheria
What is the most common cause of myocarditis worldwide?
Diphtheria
What 2 drugs can cause myocarditis?
1) Clozapine
2) Pembrolizumab
Presentation of myocarditis?
1) Chest pain
2) Systemic upset:
- fatigue
- fevers
3) SOB
4) Reduced exercise tolerance
5) Palpitations (may indicate an underlying arrhythmia)
6) Collapse
7) Sudden death
8) Signs of HF e.g. raised JVP, pulmonary oedema, peripheral oedema etc
What does chest pain in myocarditis suggest?
Concurrent pericarditis
ECG findings in myocarditis?
1) ST-segment elevation/depression
2) T wave inversion
3) Atrial arrhythmias
4) Transient AV block
What autoimmune conditions can cause myocarditis?
1) SLE
2) Sarcoidosis
What is the mainstay of mx of myocarditis?
Supportive
Complications of myocarditis?
1) Cardiogenic shock
2) Cardiac arrhythmias
3) Sudden death
4) Dilated cardiomyopathy
5) HF
Is abx prophylaxis to prevent infective endocarditis routinely recommended for dental procedures?
No
Does the murmur in mitral regurgitation become more pronounced during inspiration?
No
Does the murmur in tricuspid regurgitation become more pronounced during inspiration?
Yes
What HTN medication can worsen glucose tolerance?
Thiazides e.g. Bendroflumethiazide
Stage 1 vs 2 HTN?
Stage 1: HBPM ≥135/85 mmHg
Stage 2: HBPM ≥150/95 mmHg
Mx of stage 1 HTN?
Treat if <80 years of age AND any of the following apply; target organ damage, established cardiovascular disease, renal disease, diabetes or a QRISK ≥10%
Mx of stage 1 HTN if ≥80 y/o?
Advise lifestyle changes
Mx of stage 2 HTN?
offer drug treatment regardless of age
Ventricular hypertrophy on an ECG?
Increased amplitudes of R waves e.g. in HOCM
What is the commonest side effect caused by ivabradine?
Transient luminous phenomenon, such as bright spots appearing in their field of vision.
What medication should be considered during CPR if a PE is suspected?
Thrombolytic drugs e.g. alteplase
What 2 conditions are associated with HOCM?
1) WPW
2) Friedrich’s ataxia
What valve defect can ankylosing spondylitis cause?
Aortic regurgitation
Is amlodipine a dihydropyridine CCB or non-dihydropyridine CCB?
dihydropyridine CCB
1st line investigation for stable angina of suspected coronary artery disease aetiology?
Contrast-enhanced CT coronary angiogram
