Myocarditis

Question 1

Define myocarditis.

Answer 1

Inflammation of the myocardium in the absence of the predominant acute or chronic ischaemia characteristic of coronary artery disease. It is a clinical syndrome of non-ischaemic myocardial inflammation resulting from a heterogeneous group of infectious, immune, and non-immune diseases.

Question 2

Explain the aetiology/risk factors of myocarditis.

Answer 2

Infection
HIV
Smallpox vaccine
Autoimmune disease
Peripartum and postnatal periods

Question 3

Summarise the epidemiology of myocarditis.

Answer 3

Autopsy studies reveal myocarditis in 1% to 9% of routine postmortem examinations, and a prospective postmortem study of sudden cardiac death in young adults suggests myocarditis as the aetiology in approximately 10% of cases.

Question 4

Recognise the presenting symptoms of myocarditis.

Answer 4

Chest pain
SOB
Fatigue
Palpitations

Question 5

Recognise the signs of myocarditis on physical examination.

Answer 5

S3 gallop
Sinus tachycardia
Elevated neck veins

Question 6

Identify appropriate investigations for myocarditis and interpret the results.

Answer 6

ECG
CXR
Troponin
Echo
CK
BNP