Myocarditis

MYOCARDITIS


MYOCARDITIS

  • Inflammation of the heart muscles is called myocarditis.
  • It can be acute or chronic with involvement of the myocardium.

Etiology-

Pathogenesis-

  • Viral infection most common cause with coxsackieviruses A & B.
  • CMV, HIV, influenza virus.

Non viral infection includes-

  1. Protozoan Trypanosoma cruzi is the agent Chagas disease.
  2. Toxoplasm gondii can cause myocarditis.
  3. Spirochete Borrelia burgdorferi
  4. Non infectious diseases causes include SLE, polymositis.

Clinical features-

  • Onset of heart failure or arrhythmias
  • Fatigue, dyspnea, palpitations, pain & fever.
  • Acute CHF
  • Chest pain
  • Systemic or pulmonary emboli
  • Sudden death

Investigations-

  1. Electrocardiographic changes-
  • Includes sinus tachycardia, arrhythmias, heart block

2. Chest X-ray-

  • Reveal cardiomegaly, pulmonary oedema or pleural effusion

3. Echocardiography

  • Cardiac chamber enlargement, mitral insufficiency

4. WBC increased

5. ESR increased

6. Troponins increased

7. Creatinine, AST increased

Treatment-

  • Supportive care
  • Conventional heart failure therapy- ACE inhibitors, diuretics, Beta- blockers
  • Immunomodulation therapy
  • Anticoagulation

Exam Important

Etiology-

Pathogenesis-

  • Viral infection most common cause with coxsackieviruses A & B.
  • CMV, HIV, influenza virus.

Non viral infection includes-

  1. Protozoan Trypanosoma cruzi is the agent Chagas disease.
  2. Toxoplasm gondii can cause myocarditis.
  3. Spirochete Borrelia burgdorferi
  4. Non infectious diseases causes include SLE, polymositis.

Clinical features-

  • Onset of heart failure or arrhythmias
  • Fatigue, dyspnea, palpitations, pain & fever.
  • Acute CHF
  • Chest pain
  • Systemic or pulmonary emboli
  • Sudden death

Investigations-

  1. Electrocardiographic changes-
  • Includes sinus tachycardia, arrhythmias, heart block

2. Chest X-ray-

  • Reveal cardiomegaly, pulmonary oedema or pleural effusion

3. Echocardiography

  • Cardiac chamber enlargement, mitral insufficiency

4. WBC increased

5. ESR increased

6. Troponins increased

7. Creatinine, AST increased

Don’t Forget to Solve all the previous Year Question asked on MYOCARDITIS

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