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Infection & Immunology > Myocarditis > Flashcards

Myocarditis Flashcards

1
Q

Define Myocarditis?

A

Acute inflammation and necrosis of cardiac muscle (myocardium)

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2
Q

What is the epidemiology of Myocarditis?

A

Incidence is difficult to measure accurately
Coxsackie B virus is most common in Europe and USA
Chagas disease is most common in South America

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3
Q

What is Myocarditis usually?

A

Usually Idiopathic

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4
Q

What are the viral causes of Myocarditis?

A 
Coxsackie B 
EBV 
CMV
Adenovirus 
Influenza
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5
Q

What are the bacterial causes of Myocarditis?

A

Post-streptococcal
Tuberculosis
Diphteria

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6
Q

What is a fungal cause of Myocarditis?

A

Candidiasis

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7
Q

What is a Protozoal cause of Myocarditis?

A

Trypanosomiasis (Chagas Disease)

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8
Q

What Helminth can cause Myocarditis?

A

Trichinosis

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9
Q

What are the Non-Infective causes of Myocarditis?

A

Systemic: SLE, Sarcoidosis, Polymyositis

Hypersensitivity myocarditis: sulphonamides

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10
Q

What drugs can cause Myocarditis?

A

Chemotherapy agents (e.g. doxorubicin, streptomycin)

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11
Q

What are some other causes of Myocarditis?

A

Cocaine
Heavy Metal
Radiation

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12
Q

What are the presenting symptoms of Myocarditis?

A

Prodromal flu-like illness symptoms
Breathlessness
Palpitations
Sharp Chest Pain

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13
Q

What are the Prodromal Flu-like illness symptoms in Myocarditis?

A

Fever
Malaise
Fatigue
Lethargy

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14
Q

What is the Breathlessness in Myocarditis due to?

A

Pericardial effusion/myocardial dysfunction

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15
Q

What does sharp chest pain in Myocarditis suggest?

A

Also pericardium is present

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16
Q

What are the signs of Myocarditis on physical examination?

A

Signs of pericarditis

Signs of complications (e.g heart failure, arrhythmia)

17
Q

What bloods would you do for Myocarditis and what would you expect?

A 
FBC - raised WCC if infective cause 
U&E 
ESR/CRP - raised
Cardiac enzymes - may be raised 
Tests to identify cause (e.g. viral/bacterial serology, ANA, TFT)
18
Q

What would you see on an ECG for Myocarditis?

A

Non-specific T wave and ST changes

Pericarditis: widespread saddle-shaped ST elevation

19
Q

What would you see on a CXR for Myocarditis?

A

May be Normal

May show cardiomegaly

20
Q

Why do we do Pericardial Fluid Drainage for Myocarditis?

A

Measure glucose, protein, cytology, culture and sensitivity

Helps identify causative organism

21
Q

Why do we do Echocardiography for Myocarditis?

A

Assesses systolic/diastolic function
Wall motion abnormalities
Pericardial effusions

22
Q

What else can we do to investigate Myocarditis?

A

Myocardial Biopsy

rarely required

Infection & Immunology (40 decks)

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