Myocarditis

Question 1

Myocarditis

Answer 1

Inflammation of the myocardium - middle layer formed by cardiac myocytes.

Question 1

RF

Answer 1

Men age 20-40
Immunocompromised or Hx of autoimmune conditions
Alcohol and drugs

Question 2

Presentation

Answer 2

Young patient with acute history often with a prodromal illness.
Chest pain
Dyspnoea
Arrhythmias

Question 3

Blood markers for myocarditis

Answer 3

Raised inflammatory markers
Raised cardiac enzymes
Increase in BNP

Question 4

ECG changes myocarditis

Answer 4

Tachycardia,
arrhythmias,
ST/T wave changes such as elevation or T wave inversion.
Atrioventricular block
QTc interval prolongation

Question 5

Gold standard ix for myocarditis

Answer 5

Endomyocardial biopsy - gold standard but invasive. Catheter into heart chambers for biopsy.

Question 6

Causes of Myocarditis

Answer 6

Viral - Coxsackie B, HIV
Bacterial - diphtheria or clostridia
Lyme disease
Autoimmune
Medication - Doxorubicin

Question 7

Treatment

Answer 7

Abx if bacterial cause
Supportive treatment of complications - HF or Arrythmias.

Question 8

Complications

Answer 8

Heart Failure
Arrhythmias
Dilated cardiomyopathy