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-

a) Protozoan Trypanosoma cruzi is the agent Chagas disease.

b) Toxoplasm gondii can cause myocarditis.

c) Spirochete Borrelia burgdorferi

d) 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-

a) Protozoan Trypanosoma cruzi is the agent Chagas disease.

b) Toxoplasm gondii can cause myocarditis.

c) Spirochete Borrelia burgdorferi

d) 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

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