Myocarditis And Pericarditis

Question 1

Myocarditis

Answer 1

Inflammation of cardiac muscle, causes: infectious or non-infectious(viral - coxsackie -> first world countries protozoan - Trypanozoma Cruze -> Chaga’s disease -> South America, bacteria-Borrelia burgdorferi -> lime disease, idiopathic causes(likely viral), rheumatic fever(strep infection causes immune system to make antibodies that attack myocardium), cardiotoxic drugs(cocaine, alcohol, abuse, carbon monoxide poisoning, chemotherapy drugs(doxorubicin)), systemic diseases (lupus, Sarcoidisis, systemic scleroderma )

Question 2

Pericarditis

Answer 2

Inflammation of pericardium, causes(viruses(CMV, HIV, HSV -> first world country), TB(Mycotuberculum -> third world country), post myocardial infarction pericarditis/Dressler syndrome(approximately after one month of MI), radiation exposure(constant x-ray/CT scans of chest, leading reactive fibrosis), cancer(spread to pericardial space and trigger inflammatory response), trauma(contusion from pressing of sternum on pericardium, and that leads to immune system activating inflammatory response to heal pericardium), metabolic causes(hypothyroidism, uremia).

Question 3

Diagnosis of myocarditis and pericarditis

Answer 3

Lab(increase WBC, erythrocyte sedimentation rate increases, C- reactive protein increases, creatinine phosphatokinases increases (heart, brain or muscle cell damage), troponin(heart tissue damage, if early accuse -> myocarditis or if later presence -> pericarditis), EKG(myocarditis, sinus tachycardia: correct rhythm, but rapid rate, pericarditis: diffused ST segment(flat)) , echocardiogram(myocarditis: dilation of chamber, pericarditis: fluid visible in pericardial space)), chest x-ray(normal- < 1/2 width of mediastinum, pericardial effusion: > 1/2 width medicastinum, it can lead to cardiac tamponade (heart is under pressure and can’t pump, symptoms: hypertension, jugular, distention, distant heart sounds), myocarditis: enlarged heart(cardiomegaly), CT scan(pericarditis: big dark ring around the heart on transverse plane cut) cardiac catheterization(a catheter is placed in heart, enters through leg, measures pressures(myocarditis: low pressure in affected chamber, pericarditis: equal pressure in all chambers) can also be used forEndomyocardial biopsy(takes a sample of myocardium piece).

Question 4

Myocarditis and Pericarditis treatment

Answer 4

Supportive care(limit physical activity, sleep with elevated head, oxygen therapy), medication’s(antibiotics, anti-inflammatory/NSAIDS/colchicinel steroids , anti-hypertensive(beta blockers, ACE inhibitors, diuretics)
Procedures (Extracorporeal membrane oxygenation(machine acts like lungs, heart), pericardiocentesis (needles to drain a pericardial space), Pericardiotomy (make permanent channel between pericardial space and chess cavity).