Myocarditis and Pericarditis Flashcards
What is myocarditis?
Inflammation of myocardium
Can impair myocardial function, cause arrhythmia and take on the appearance of dilated cardiomyopathy
What can cause myocarditis?
Acute= viral most common, associated with pericarditis Chronic= autoimmune
What is the presentation of myocarditis?
Heart failure= fatigue, exertion SOB, orthopnoea, oedema
Arrythmia
ACS like symptoms
What investigations are done for myocarditis?
ECG Echo Cardiac MRI Troponin, CRP, ESR Endomyocardial biopsy Investigate cause
What is seen on ECG with myocarditis?
ST changes, T wave inversion
Arrythmia
What is the gold standard investigation for myocarditis?
Endomyocardial biopsy
What is the management of myocarditis?
Symptomatic= ACEi, diuretics, BB
Corticosteroids
IVIg
What is pericarditis?
Inflammation of pericardial layers, with or without myocardial involvement
What can cause pericarditis?
Viral= most common Bacterial Post MI Neoplasm Idiopathic Autoimmune- SLE, RA, vasculitides
What is the presentation of pericarditis?
Sudden onset chest pain= relieved sitting forwards, worse lying Muffled heart sounds Pericardial rub Fever Hypotension
What investigations are done for pericarditis?
ECG
Echo
Troponin
What is seen on ECG with pericarditis?
Saddle shaped ST elevation
PR depression
What is the troponin in pericarditis?
Normal
often elevated if myocardial involvement
Good to distinguish
What is the management of pericarditis?
NSAIDs and colchicine
Steroids if NSAIDs contraindicated
What is a pericardial effusion?
Fluid in pericardial sac
Can be acute or chronic
Can lead to cardiac tamponade