Myocarditis + Pericarditis

Question 1

What is myocarditis?

Answer 1

Acute myocardial inflammation

Flabby heart with focal haemorrhages and inflammatory infiltrates

Question 2

Causes of myocarditis

Answer 2

C infections - coxsackie, cytomegalovirus, Chagas disease, also adenovirus
Drugs causing hypersensitivity
Radiation

Question 3

S/S of myocarditis

Answer 3

Palps, dyspnoea, HF, fatigue, chest pain

Question 4

Investigations of myocarditis

Answer 4

CXR - cardiac enlargement
ECG - ST/T abnormalities, arrhythmias, heart block
Bloods - raised CK and troponin

Question 5

Treatment of myocarditis

Answer 5

1. Treat underlying cause - antibiotics where appropriate
2. Bed rest when acute, avoid athletics for 6m
3. ACEI, B-blockers, spironolactone, digoxin

Question 6

Patient has a fever and pleuritic chest pain that is relieved by sitting up and leaning over

Answer 6

Pericarditis

Question 7

Causes of pericarditis

Answer 7

viral, TB, uraemia, trauma, post MI/CABG (Dressler’s), connective tissue diseases

Question 8

S/S of pericarditis

Answer 8

Fever, pleuritic pain, pericardial rub, pulsus paradoxus, flu-likw, dyspnoea, tachypnoea, tachycardia

Question 9

Investigations of pericarditis

Answer 9

CXR

ECG - saddle-shaped ST elevation, PR depression

Question 10

Treatment of pericarditis

Answer 10

NSAIDS - ibuprofen

Question 11

Flabby heart with focal haemorrhages and inflammatory infiltrates

Answer 11

Myocarditis