Myocarditis Flashcards
what is the definition of myocarditis
acute inflammation and necrosis of cardiac muscle
what is the aetiology of myocarditis
idiopathic (common) infective non-infective drugs others
what are the infective causes of myocarditis
viruses(coxsackie B, echovirus, EBV, CMV, adenovirus, influenza)
bacteria(post-streptococcal, TB, diptheria, lymes disease)
fungal(candidiasis)
protozoal(trypanosomiasis-Chagas disease)
helminths(trichinosis)
what is lymes disease
bacterial infection spread by ticks
what are the non-infective causes of myocarditis
splenic disorders(SLE/sarcoidosis) hypersensitivity myocarditis (sulphonamides)
what are the drugs which cause myocarditis
chemotherapy agents(doxorubicin/streptomycin) cocaine
what are the other causes of myocarditis
heavy metal
radiation
what is the epidemiology of myocarditis
common in young
coxsackie B-common in europe and USA
chagus disease-common in south america
what history would be expected with myocarditis
prodromal “flu”(fever/malaise/fatigue)
SOB(pericardial effusion/myocardial dysfunction)
palpitations(irregular HB)
sharp chest pain(pericarditis)
what examination findings would be expected with myocarditis
signs on concurrent pericarditis
signs of complications(HF/arrhythmias)
what investigations would be performed in suspected myocarditis
1 bloods -FBC(increased WCC with infection) -UEs, increased ESR, CRP, cardiac enzymes may be raised 2 ECG -T wave+ST changes -widespread saddle-shaped ST elevation in pericarditis 3 CXR -may show cardiomegaly+/pulmonary oedema 4 pericardial drainage -measure glucose/protein/cytology/culture&sensitivity 5 echo -assess systolic/diastolic function -assess wall motion abnormalities -pericardial effusion 6 myocardial biopsy
what is the most important aspect of the bloods investigation
to identify cause
- viral/bacterial serology
- ANA
- antistreptolysin O titre
- serum ACE
- TFT
