Myocarditis

Question 1

Whilst most recover what may occur?

Answer 1

Persistent low grade myocarditis or dilated cardiomyopathy some 10-20 years later

Question 2

Name the classifications of causes for myocarditis e.g. Viral

Answer 2

Viral, bacterial, protazoal, autoimmune, radiation, drugs, poisoning

Question 3

Name a viral cause

Answer 3

Coxsackie B, adenovirus, echovirus, influenza, rubella

Question 4

Name a bacterial cause

Answer 4

Diphtheria, chlamdyia, coxiella, lymes disease (borrelia burgdoferi)

Question 5

Name a protazoal cause (optional)

Answer 5

Trypansoma cruzi (chagas disease)

Question 6

Name an autoimmune cause

Answer 6

Sarcoidosis, connective tissue diseases

Question 7

Less severe but important symptoms include?

Answer 7

Dyspnoea, chest pain and fatigue

Question 8

Focal inflammation can lead to what?

Answer 8

Arrythmias that may be heard, cause palpitations or even sudden death occasionally

Question 9

What heart sounds might you be listening for?

Answer 9

Soft s1, s3, murmurs from mitral/tricuspid regurgitation

Question 10

What investigations might you do?

Answer 10

ECG, CXR, echo, serum Cr kinase, assays of coxsackie B

Question 11

What is the main goal of treatment?

Answer 11

Supportive, plenty of bed rest and no exercise for several months giving HF drugs if HF is present. Steroids may be given on the rare occasion it is cardiac biopsy proven

Question 12

What is it?

Answer 12

An acute, potentially reversible, inflammation of the myocardium