Myocarditis

Question 1

Define myocarditis

Answer 1

Inflammation of heart muscle

Question 2

What is the epidemiology behind myocarditis?

Answer 2

Can lead to reduced heart function, heart block, heart failure + arrhythmias
Can take a dilated cardiomyopathy appearance

Question 3

What is the aetiology?

Answer 3

Idiopathic 50%
Viral - Flu, hep, mumps
Bacterial (TB)
Spirochaetes

Question 4

What are the clinical symtoms?

Answer 4

Heart failure
Fatigue 
SOB
Palpitations
Chest pain 
May/may not have fever

Question 5

What are the clincal signs?

Answer 5

Tachycardia

Soft S1, S4 Gallop

Question 6

What are the investigations?

Answer 6

ECG
ECHO
CMRI - oedema
Positive troponin 1 or T level - confirm diagnosis
Strep antibodies + HIV
Low threshold for biopsy

Question 7

What are you looking for in an ECG?

Answer 7

ST elevation/depression
T wave inversion
Atrial arrythmias
AV block

Question 8

What is the treatment?

Answer 8

Supportive - treating heart failure + brady/tachy
Treat underlying cause
Immunotherapy
Stop possible drug exposure