Myocarditis

Question 1

what is the treatment for myocarditis ?

Answer 1

treat underlying cause 
antibiotics 
avoid NSAIDS in acute phase but can use in chronic 
avoid exercise for 6 months 
treat any symptoms of heart failure

Question 2

what is the cause of myocarditis?

Answer 2

most commonly in western world - coxsackie virus & adenovirus

most common globally especially in south america - Chagas disease (trypanosoma cruzi)

Question 3

what is the presentation of myocarditis?

Answer 3

presentation ranges from asymptomatic with focal inflammation to dyspnoea, chest pain, fatigue, palpitations, congestive heart failure with diffuse myocardial involvement

Question 4

what signs on examination could you illicit in myocarditis?

Answer 4

prominent S3 heart sound
soft heart sounds
tachycardia
pericardial friction rub (may be heard)

Question 5

what investigations would you carry out if you suspected myocarditis and what would they show?

Answer 5

ECG - ST and T wave changes, arrhythmia

cardiac enzymes - elevated

CXR - cardiac enlargement

end-myocardial biopsy - acute inflammation

viral antibody titres
viral RNA