Myocarditis (Complete) Flashcards
Define myocarditis
Inflammation of the myocardium
Myocarditis in conjunction with pericarditis is known as?
Myopericarditis
What are the 3 main aetiological causes of myocarditis?
Infection (e.g. HIV, diptheria, lyme’s disease)
Autoimmune
Drugs (e.g. doxorubicin type of chemotherapy)
List 7 examples of infections which can result in myocarditis
Viral: HIV, Coxsackie B
Bacterial: Diptheria, Clostridia
Lyme disease
Chaga’s disease
Toxoplasmosis
What are the main signs/symptoms of myocarditis? (6)
Viral prodrome 2-3 weeks prior to cardiac symptoms is common
Cardiac-type chest pain
Dyspnoea
Arrythmias
Palpitations
Fatigue
Symptoms of heart failure
Usually presents in young patients
What findings on examination can present in patients with myocarditis? (3)
Signs of heart failure
Pericardial friction rub (If myopericarditis)
Often examination findings are non-specific
What risk factors are associated with myocarditis? (5)
Age < 50 years
HIV
Autoimmune conditions (e.g. SLE)
Previous or recent infection
Pregnancy (peri-natal or post-natal)
What investigations should be ordered in patients suspected of having myocarditis? (5)
Bedside:
ECG [Non specific ST elevation and T wave inversion changes]
Bloods:
Troponin
ESR
CRP
BNP [All raised]
Imaging:
Cardiac MRI [Show inflammation]
What blood test findings support a diagnosis of myocarditis? (3)
ESR: Raised
CRP: Raised
Troponin: Markedly raised
BNP: Raised
What is the gold-standard diagnostic tool for myocarditis?
Endomyocardial biopsy via cardiac catheterisation (However is inavsive and has own risks)
What is the management plan for patients with myocarditis? (3)
Treat underlying cause: E.g. antibiotics
Supportive management: Treat complications of heart failure or arrythmias.
Lifestyle support: Limit activity for a few months
What complications can arise in patients with myocarditis? (4)
Sudden cardiac death
Arrythmia (which can lead to sudden cardiac death)
Heart failure
Dilated cardiomyopathy (late complication)
