Myocarditis Flashcards
causes
Chagas' disease viral bacterial fungal immunodeficiency toxin drugs immune conditions
who does it commonly affect?
<50 years
viral causes
parovirus B19 rubella coxsackie adenovirus EBV hepatitis C
chagas’ disease
protozoa
worldwide most common cause of myocarditis
toxins/drugs that cause myocarditis
amphetamines
cocaine
arsenic
cyclophosphamide
immune conditions that cause myocarditis
SLE
sarcoidosis
scleroderma
what is myocarditis?
inflammation of myocardium without acute/chronic ischaemia
pathophysiology
infectious organism invades myocardium local and systemic immunological activation cellular and humoral immune activation worsened local inflammation anti-heart antibody production myonecrosis
investigations
bloods FBC U&Es LFTs ECG CXR CRP Echo consider MRI hard to distinguish from acute coronary syndrome
blood results
raised CRP
raised troponin
ECG results
minor ST depression non-specific changes QRS/QT prolongation diffuse T wave inversion ventricular arrhythmias AV conduction defects widespread ST changes sinus tachycardia
clinical features
very variable
usually benign without significant complications
often preceded by viral illness 2-3 weeks prior
examples of clinical features
leg swelling chest pain syncope palpatations arrhythmias cardiac failure dilated cardiomyopathy SOB progressive fatigue low O2 sats raised RR bilateral crepitations low BP tachycardia raised JVP pitting oedema pulmonary oedema
CXR results
hazy widespread opacification
obscured costophrenic angle
cardiomegaly
pulmonary oedema
management
analgesia ACE inhibitors vasodilators beta blockers oxygen diuretics - spironolactone treat underlying cause
prognosis
varied
often prompt and full recovery but can be fatal/cause significant morbidity
