Myocarditis

Question 1

What is myocarditis

Answer 1

Inflammatory disease of the cardiac muscle

Question 2

What are most common cause of myocarditis

Answer 2

viral infection, Such as parvovirus, Epstein Barr virus
Cytomegalovirus
coxsackie b

Question 3

Acute myocarditis, symptoms of heart failure over less than __ months

Answer 3

3

Question 4

Subacute/ chronic myocarditis symptoms of heart failure develop over more than __ months

Answer 4

3

Question 5

Other non infectious cause of myocarditis

Answer 5

alcohol or cocaine
Bacteria, rickettsial, lymes bartonella
Other ABX, diuretics

Question 6

Myocarditis acute clinical presentation (less than 3 months)

Answer 6

1. Acute coronary syndrome
2. Heart failure, Dyspnea, peripheral edema, chest pain, and fatigue
3. Arythmia, or cardiogenic shock

Question 7

Symptoms greater than 3 months is what kind of myocarditis

Answer 7

Subacute or chronic myocarditis

Question 8

Symptoms of myocarditis are consistent with what?

Answer 8

Consistent with acute coronary syndrome, heart failure or an arrhythmia

Question 9

Main signs of myocarditis

Answer 9

Chest pain, Dyspnea, syncope, arythmia

Question 10

What to ask about in assessing potential myocarditis

Answer 10

Ask recent travel, recent viral illness, or bacterial illness ?

Question 11

Physical exam finding for myocarditis

Answer 11

Consistent with acute coronary syndrome such as peripheral edema and may have jvd, Ascites

Question 12

Workup for myocarditis involves

Answer 12

EKG’s may show T wave inversions, sinus Tachy or other arythmia
BNP and troponin may be elevated
Chest X-ray may show cardiomegaly
May have s3 gallop
Mimic acute coronary syndrome

Question 13

Tx for myocarditis

Answer 13

Treat underlying symptoms.
If heart failure, tx with ace, arb, loop
If arythmia, treat arythmia

Depends on acuity, and etiology

Question 14

What to avoid in myocarditis

Answer 14

NSAID,
Alcohol
Excess exercise

Question 17

What to ask in history if suspect myocarditis

Answer 17

Ask new meds, recent illness, or recent travel

Question 18

You have a 30 year pt presents, with chest discomfort mild shortness of breath, he had a recent fever, u checked ekg and noted ST elevations, and then checked echo what are u expecting to find on an echocardiogram?

Answer 18

Expecting to see reduced ejection fraction at 35% and global hypokinesis (reduced movement of the myocardium]

Question 19

What to educate pt on avoiding in myocarditis

Answer 19

NSAID AND ALCOHOL AND EXCESS EXERCISE