Myocarditis

Question 1

Definition of Myocarditis

Answer 1

• Inflammation of the myocardium in the absence of the predominant acute or chronic ischaemia characteristic of CAD

Question 2

Aetiology of Myocarditis

Answer 2

• Idiopathic
• Viral
• Bacterial (S. aureus, syphilis)
• Drugs (i.e. cyclophosphamide, Herceptin, CBZ, phenytoin)
• Autoimmune (giant cell myocarditis associated with SLE)

Question 3

Signs and Symptoms of Myocarditis

Answer 3

• Signs/symptoms include fever, sore throat, myalgia, dyspnoea, fatigue, chest pain, arrhythmia, palpitations, soft S1 and S4 gallop.

Question 4

Investigation of Myocarditis

Answer 4

• ECG
  
  • ST-elevation or depression
  • T wave inversion
  • Transient AV block
• Troponin
  
  • Positive

Question 5

Management of myocarditis

Answer 5

• Treat underlying cause
• Supportive management (includes management of acute heart failure)