Myocarditis

Question 1

Myocarditis

Answer 1

Myocarditis describes inflammation of the myocardium. There are a wide range of underlying causes. It should be particularly considered in younger patients who present with chest pain.

Question 2

Causes of myocarditis

Answer 2

	viral: coxsackie B, HIV
	bacteria: diphtheria, clostridia
	spirochaetes: Lyme disease
	protozoa: Chagas' disease, toxoplasmosis
	autoimmune
	drugs: doxorubicin

Question 3

Presentation of myocarditis

Answer 3

>

usually young patient with an acute history
chest pain
dyspnoea
arrhythmias

Question 4

Investigations in myocarditis

Answer 4

Bloods
o ↑ inflammatory markers in 99%
o ↑ cardiac enzymes
o ↑ BNP

ECG
o tachycardia
o arrhythmias
o ST-segment elevation and T wave inversion

Question 5

Blood results in myocarditis

Answer 5

↑ inflammatory markers in 99%
↑ cardiac enzymes
↑ BNP

Question 6

ECG changes in myocarditis

Answer 6

o tachycardia
o arrhythmias
o ST-segment elevation and T wave inversion

Question 7

Complications in myocarditis

Answer 7

• heart failure
• arrhythmia, possibly leading to sudden death
• dilated cardiomyopathy: usually a late complication

Question 8

Management of myocarditis

Answer 8

• treatment of underlying cause e.g. antibiotics if bacterial cause
• supportive treatment e.g. of heart failure or arrhythmias