myocarditis

Etiology

(see etiology of myocarditis)

• infectious
  • viral
  • bacterial
  • fungal
  • parasitic
• non-infectious
  • connective tissue diseases
  • thyrotoxicosis
  • thrombotic thrombocytopenic purpura (TTP)
  • pheochromocytoma
  • peripartum
  • radiation
  • pharmaceutical agents
  • Kawasaki disease
  • giant cell myocarditis
  • sarcoidosis
  • spider bites
  • wasp stings
  • scorpion bites

Clinical manifestations

• preceeding acute viral syndrome
• acute biventricular dysfunction
• ventricular arrhythmias
• may mimic acute coronary insufficiency

Laboratory

• serum creatine kinase MB (serum CK-MB) may be elevated
• cardiac-specific troponin-I may be elevated
• myocardial biopsy
  • myocarditis in a patient who resides in an area where Trypanosoma cruzi is endemic
  • eosinophilia & trichinosis is suspected

Diagnostic procedures

• electrocardiogram:
  • ventricular arrhythmias
  • T-wave inversions
  • ST segment changes may occur

Differential diagnosis

• idiopathic cardiomyopathy is not associated with elevated cardiac biomarkers

Management

• first-line treatment is standard heart failure therapy
  • diuretics
  • ACE inhibitor, ARB or ARNI
  • beta-blocker (unless decompensated heart failure)
  • aldosterone antagonist
• rest
• salt & fluid restriction
• no benefit of corticosteroids, azathioprine or cyclosporine
• complete functional recovery in most patients

More general terms

• carditis

More specific terms

• giant cell myocarditis

Additional terms

• etiology of myocarditis

Patient information

myocarditis patient information