Myocarditis

Headline
Etiology - Drug-related:
- clozapine
- Lithium
- cocaine
- post-viral - initial viral infection may be asymptomatic
- rheumatic fever
- autoimmune - sarcoid, SLE, scleroderma...
- active viral - Coxsackie, HIV
- some parasitic infections e.g. Chagas disease, trichinosis
Clinical presentation - tachycardia, gallop rhythm
- decompensated heart failure
- pericardial rub
- cardiogenic shock

ECG changes:
- T wave inversion
- widened QRS?
- heart block
Pathogenesis myocardial necrosis
Diagnostic investigations Echo
- Viral serology - HIV, Hep C, parvovirus, HHV6
- lupus screen
- coeliac disease screen
- anti-myosin antibodies
- anti beta-1 adrenoreceptor antibodies
- quantiferon gold for TB
- ASOT
Management Supportive as for cardiogenic shock
and for heart failure - ACEis, beta blockers, aldosterone antagonists

#pathology

cardiogenic shock

https://emcrit.org/ibcc/myocarditis/
https://litfl.com/myocarditis/