Myocarditis Flashcards
define myocarditis?
it is the acute inflammation and necrosis of the cardiac muscle.
what is the epidemiology of myocarditis?
Coxsackie B virus is most common in Europe and USA
Chagas disease is most common in South America
what are the causes of myocarditis?
- viruses
- bacteria
- fungal
- protozoal
- helminths
- non infective
- drugs
- others
example of a virus bacteria fungal, protozoal and helminth cause of myocarditis?
virus - coxsackie b bacteria - post streptococcal fungal - candidiasis protozoal - Trypanosomiasis helminth - trichinosis
example of a non-infective cause of myocarditis?
can be either systemic or hypersensitive
- systemic = SLE
- hypersensitive = sulphonamides (ADR)
what drugs can cause myocarditis?
- chemotherapy agents eg. doxorubicin
what other things can cause myocarditis?
- cocaine
- heavy metals
- radiation
what are the presenting symptoms of myocarditis?
flue like symptoms like …
- fever
- malaise
- fatigue
- lethargy
- breathlessness
- palpitations
- sharp chest pain
what are the signs of myocarditis on examination?
- Signs of pericarditis
- Signs of complications (e.g. heart failure, arrhythmia)
what investigations should be carried out for myocarditis?
- bloods
- ECG
- CXR
- pericardial fluid drainage
- echo
- myocardial biopsy
what might bloods of myocarditis show?
- FBC = raised WCC
- Us and Es
- ESR/CPR raised
- cardiac enzymes raised
what might an ECG show?
- non-specific T wave and ST changes
- any pericarditis will show widespread saddle-shaped ST elevation
what might a CXR show?
- could be normal
- might show cardiomegaly
what does the pericardial fluid drainage measure?
- Measure glucose, protein, cytology, culture and sensitivity
- it will help to identify the causative agent
what will an echo show?
- it assesses systolic and diastolic function
- will detect wall motion abnormalities
- can detect pericardial effusions.
