Myocarditis

Question 1

What is myocarditis.

Answer 1

Inflammation of the myocardium.

Question 2

What are the causes of myocarditis. (7)

Answer 2

Infection (bacterial viral).
Drugs (penicillin, methyldopa, spironolactone, phenytoin).
Idiopathic (50%).
Radiation.
Toxins.
Vasculitis.
Commonest cause is viruses (flu, hepatitis, mumps, rubeola, coxsacie, polio, HIV).

Question 3

What is the most common viral cause of myocarditis.

Answer 3

Coxasackie virus.

Question 4

What are the symptoms of myocarditis. (9)

Answer 4

Very variable. 
It may be asymptomatic. 
Chest pain. 
Fatigue. 
Dyspnoea.
Fever.
Tachycardia.
Heart failure.
Palpitations. 
Death.

Question 5

What are the clinical signs of myocarditis. (4)

Answer 5

Often there are none.
Soft S1.
S4.
Pansystolic murmur (MR).

Question 6

What is seen on the ECG of a patient with myocarditis. (4)

Answer 6

ST elevation or depression.
T wave inversion.
Atrial arrhythmias.
Transient AV block.

Question 7

What are the complications of myocarditis. (3)

Answer 7

Heart failure.
Chronic myocarditis.
Dilated cardiomyopathy.