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Alterations Resulting in Decreased Cardiac Output > Myocarditis > Flashcards

Myocarditis Flashcards

1
Q

What is Myocarditis?

A

is an inflammation of the myocardium, or heart muscle

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2
Q

Why is myocarditis uncommon and poorly understood inflammation of the myocardium?

A

because at least several weeks (in some cases, a decade) elapse between exposure to the causative agent and the development of symptoms.

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3
Q

What usually causes Myocarditis?

A

INFECTIONS

  • viral
  • bacterial
  • protozoal
  • fungal
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4
Q

What bacteria usually causes Myocarditis?

A
  • Corynebacterium diphtheriae
  • Staphylococcus aureus
  • Lyme disease
  • Chlamydia
  • Mycoplasma
  • Streptococcus
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5
Q

What viral infections usually cause Myocarditis?

A
  • influenza
  • coxsackie
  • cytomegalovirus
  • adenovirus
  • hepatitis C
  • herpes
  • HIV
  • parvovirus
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6
Q

In myocarditis what can damage the heart muscle?

A
  • Organisms
  • blood cells
  • toxins
  • immune substances
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7
Q

Other causes of Myocarditis may include?

A
  • allergic reactions
  • chemical exposure
  • radiation
  • inflammatory disorders (rheumatoid arthritis or sarcoidosis).
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8
Q

What are the inflammatory disorders that may cause Myocarditis?

A
  • Rheumatoid arthritis

- Sarcoidosis

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9
Q

The result in muscle fiber dysfunction and degeneration that can impair contractility and conduction are?

(what penetrates into the myocardium)

A

Penetration of organisms, blood cells, toxins, and immune substances.

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10
Q

What are some complications of Myocarditis?

A
  • heart failure
  • cardiomyopathy
  • dysrhythmias
  • thrombus development
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11
Q

This cardiac condition occurs/affects mostly what population?

A

Most often effects young atheletic with age group puberty- 30 yo, males > females

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12
Q

The clinical manifestations of myocarditis include?

Myocarditis can also be asymptomatic

A

IF PRESENT

  • flulike symptoms (fever, chills, myalgia)
  • Pericarditis symptoms (chest pain, friction rub)
  • Heart failure symptoms (dyspnea, edema, activity intolerance, or pale, cool skin)
  • dyspnea
  • dysrhythmia
  • palpitations
  • tachycardia
  • heart murmurs
  • chest discomfort
  • cardiomegaly
  • pale and cool extremities
  • syncope
  • decreased urine output
  • joint pain/swelling
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13
Q

What are the classification systems to aid in the diagnosis of acute myocarditis?

A
  • Possible subclinical acute myocarditis
  • Probable acute myocarditis
  • Definite myocarditis
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14
Q

What is a diagnosis based on in”Possible subclinical acute myocarditis”?

A
  • without specific symptoms that can be inferred based on transient increases in troponin or EKG changes after a viral illness, adverse drug reaction, or vaccination (rarely).
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15
Q

What is a diagnosis based on in “Probable acute myocarditis?

A

the presence of one of four clinical syndromes associated with myocarditis:

  • chest pain
  • acute heart failure
  • presyncope or syncope
  • myopericarditis (myocarditis with pericarditis).
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16
Q

What is a diagnosis based on in “Definite myocarditis”?

A

confirmed by histological analysis of heart tissue.

17
Q

Describe Myocarditis resembling a MI (myocardial infarction)?

A

Myocarditis can present with:

  • Chest pain
  • Reversible occlusion
18
Q

When resembling a MI, Myocarditis can present with chest pain because?

A

The inflammation of the coronary arteries.

19
Q

When resembling a MI, Myocarditis can present with “Reversible occlusion” because?

A

Due to vasospasm can result from an influx of inflammatory cells.

20
Q

When resembling a MI, Myocarditis can present with chest pain that worsens with?

A

leaning backward

21
Q

When resembling a MI, Myocarditis can present with chest pain that improves with?

A

leaning forward; this condition is classically associated with pericarditis, which often accompanies myocarditis of the outer layers of the myocardium.

22
Q

What are the symptoms of pericarditis?

A
  • chest pain

- friction rub

23
Q

What are the symptoms of Heart Failure?

A
  • dyspnea
  • edema
  • activity intolerance
  • pale
  • cool skin
24
Q

How long can it take for symptoms to develop in myocarditis?

A

Can be weeks to decade btwn exposures and symptoms development

25
Q

How is Myocarditis Diagnosed?

A
  • history
  • physical examination
  • blood cultures
  • EKG
  • cardiac biomarkers
  • CBC
  • ESR
  • chest X-rays
  • echocardiogram
  • endomyocardial biopsy
26
Q

what cardiac biomarkers are used for the diagnosis of Myocarditis?

A

troponin and creatinine kinase

27
Q

What is the GOLD standard for diagnosing Myocarditis?

A
  • endomyocardial biopsy

risky and should only be done if absolutely necessary

28
Q

What can be given in treating the causative agent (in myocarditis)?

A

antibiotics for bacterial infections

29
Q

The treatment for Myocarditis is?

A
  • resolve the underlying cause
  • antipyretics
  • anticoagulants
  • antidysrhythmics
  • diuretics
  • immunosuppressants
  • rest/activity restriction
  • fluid limitation
30
Q

What treatments are given in myocarditis to reduce cardiac workload?

A
  • increasing bed rest
  • restricting activity
  • limiting fluids
31
Q

In the treatment of myocarditis which immunosuppressants are used to treat symptoms or complications?

A

corticosteroids or nonsteroidal anti-inflammatory drugs

Alterations Resulting in Decreased Cardiac Output (13 decks)

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