Sketchy Path: Myocarditis Flashcards
The most common cause of myocarditis in the United States is _____________.
viral myocarditis (like the Coxsackie B Cockatoo on the bartender’s shoulder)
Describe the pathogenesis of viral myocarditis.
Viral myocarditis starts with direct viral damage to the myocytes (like how the bird is DIRECTLY on her shoulder), but then inflammatory cells invade and make the inflammation worse (like the blue bird seed on the bar).
While most viral myocarditis is self-limited, it is prolonged in some people due to ______________.
antibodies that develop against exposed myocyte proteins (like the antibody toothpicks on the bar)
Viral myocarditis can progress to ______________.
dilated cardiomyopathy (like the dilated bag behind the bartender)
Because viral myocarditis is caused by viruses that can infect other parts of the body, ______________ will clue you in to the correct diagnosis.
recent influenza-like symptoms
More than half the people in endemic areas of S. America have ____________.
Chagas’ disease, which can cause DCM
Histologic exam of the hearts of those with Chagas’ disease will often show _____________.
lense-shaped nests of protozoa (like the lense-shaped bowl of blueberries)
Which bacteria is most high-yield for myocarditis?
Borrelia burgdorferi (like the poster for Robin of Ixodes above the bar)
Although it is rare, _____________ can cause myocarditis in the immunosuppressed.
fungi (like the mushroom-shaped handle)
What toxins can cause myocarditis?
- Doxorubicin (the box of rubies)
* C. diphtheria toxin (like the chips and DIP)
Some drugs can cause a type _________ hypersensitivity reaction that leads to myocarditis.
IV (delayed)
Think of the guy mixing drinks for later from the squire brand liquor.
How might you diagnose a delayed hypersensitivity myocarditis?
They will usually present with systemic symptoms like fever, joint pain, etc.
What autoimmune disorders can cause myocarditis?
Lupus, RA, and scleroderma
Think of the antibody darts on the heart-shaped dart board in the back.
What inflammatory patterns are found in acute rheumatic fever?
Antibodies directed against M protein attack the myocardium (like the girl with the RHUbarb PIE ducking under the darts).
What symptoms suggest myocarditis?
- Fever (guy with flame bandana)
- Dyspnea (guy exhaling while throwing darts)
- Chest pain (guy getting hit in the chest by a dart)
- CK and troponin elevations (guy with elevated steak and spilled ChicKen)
- Arrhythmia (guy fell over with heart buzzing on his iPhone on his chest)
