Presentation
A rationalisation of the 1350 boxes used throughout the book gives a simpler and clearer presentation of the various categories. [books.google.com]
ECG Commonly sought due to the clinical presentation, but demonstrates poor sensitivity. [radiopaedia.org]
Dermatomyositis : Degeneration ; Loss of striation ; Vacuolization and necrosis of muscle fibres may be seen ; Interstitial edema may be present ; Inflammatory infiltrate composed of mainly lymphocytes and histiocytes is present interstitially or perivascularly [histopathology-india.net]
A pericardial friction rub from pericarditis may be present. Ewart’s sign is dullness to percussion at the left lung base due to compressive atelectasis from a large pericardial effusion. [healio.com]
International occurrence A population study in Finland found that, in a study of more than 670,000 healthy young male military recruits, 98 cases had myocarditis mimicking myocardial ischemia, 1 case presented as sudden death, and 9 cases presented as [emedicine.medscape.com]
Entire Body System
- Congestive Heart Failure
Antiarrhythmic drugs may be required, as well as therapy to combat congestive heart failure. If the heart involvement becomes chronic, treatment then must be aimed at management of the chronic heart failure. [medical-dictionary.thefreedictionary.com]
Congestive heart failure is when the heart is unable to pump enough blood throughout the body. Chemotherapy can cause mild or severe damage to the heart. If severe, congestive heart failure or other life-threatening problems can occur. [nccn.org]
Myocarditis may be suspected whenever chest pain or arrhythmia symptoms suggestive of congestive heart failure occur during the course of an infectious illness, especially a viral one. [healthcentral.com]
Acute decompensated congestive heart failure with dilated cardiomyopathy : See symptoms of left heart failure and symptoms of right heart failure. [amboss.com]
CXR: Normal cardiac silhouette but pericarditis or overt clinical congestive heart failure is associated with cardiomegaly. Vascular redistribution. Interstitial and alveolar oedema. Pleural effusion. [patient.info]
- Coronary Atherosclerosis
Ischemic cardiomyopathy is generally ascribed to epicardial coronary atherosclerosis, but it can also occur in any vasculitic process (eg, Takayasu's arteritis), congenital abnormalities (including aberrant coronary arteries), embolic conditions (eg, [clevelandclinicmeded.com]
Cardiovascular
- Chest Pain
However, acute pericarditis is more likely if inspiration and supine position worsens the chest pain, and sitting upright and leaning forward alleviates the chest pain; the pain in STEMI is unaffected by position. [ecgwaves.com]
Rapid or abnormal heart rhythms (arrhythmias) When to see a doctor Contact your doctor if you have symptoms of myocarditis, particularly chest pain and shortness of breath. [mayoclinic.org]
When To Call a Professional Call your doctor immediately if you have chest pain, even if you think that you are too young to be having heart problems. [drugs.com]
If chest pain, trouble breathing, or swelling have gotten worse since you were told you have myocarditis, call 911 or go to the hospital. Treatment If you have myocarditis, your doctor will treat its cause, if possible. [webmd.com]
- Vascular Disease
Fungi : Aspergillus, Candida, Cryptococcus, Histoplasma, Coccidioides Parasites : Trypanosoma cruzi, T. gambiense, T. rhodesiense, T. spiralis, Toxoplasma gondii, Schistomsoma species, visceral larval migrans Other : idiopathic, collagen vascular disease [hopkinsguides.com]
and non-infectious forms (ie, cardiotoxic drugs, collagen vascular diseases, systemic illnesses such as sarcoidosis, and rheumatic fever). 5-8 Myocarditis should be suspected when patients present with otherwise unexplained cardiac abnormalities such [clevelandclinicmeded.com]
Workup
(See Etiology, Clinical, and Workup.) [emedicine.medscape.com]
X-Ray
- Pericardial Effusion
Introduction A pericardial effusion occurs when a significant amount of fluid fills the pericardial space. [healio.com]
[…] fraction, impaired contractility, regional wall motion abnormalities Pericardial effusion : localized or circumferential fluid surrounding the ventricles Exclusion of other possible etiologies of heart failure (e.g., heart defects) Cardiac MRI Diagnosis [amboss.com]
effusion (and potential tamponade physiology). [radiopaedia.org]
Common bugs Cocksackie A and B Echovirus Adenovirus Viral infections uncommon in patients presenting with pericardial effusion w/o pericarditis Exception is HIV- frequently presents with significant effusion w/o pericarditis seen in 7 [slideshare.net]
The 2D echocardiography obtained in the emergency department showed a normal sized non-hypertrophic left ventricle with inferior wall hypokinesis and normal global systolic function, with no pericardial effusion. [revespcardiol.org]
Microbiology
- Chlamydia
[…] rickettsial : C. diphtheriae, C. perfringens, Mycoplasma pneumoniae, S. pyogenes (toxin-mediated, acute rheumatic fever ), S. pneumoniae, N. meningitidis, N. gonorrhoeae, Salmonella, H. influenzae, Brucella, S. aureus, Listeria, Legionella, Mycoplasma, Chlamydia [hopkinsguides.com]
Some things that can cause myocarditis include: Coxsackie B viruses Epstein-Barr virus ( EBV ) Cytomegalovirus ( CMV ) Hepatitis C Herpes HIV Parvovirus Chlamydia (a common sexually transmitted disease ) Mycoplasma (bacteria that cause a lung infection [webmd.com]
It may also be caused by bacterial infections such as Lyme disease, streptococcus, mycoplasma, and chlamydia. [stlukes-stl.com]
Other Pathologies
- Myocardial Fibrosis
In general, potential heart-related adverse events from immunotherapy are myocardial fibrosis, myocarditis, and acute heart failure, which have been reported among patients treated with programmed cell death protein-1 (PD-1) pathway immunotherapy, noted [medpagetoday.com]
Applicable To Chronic (interstitial) myocarditis Myocardial fibrosis Myocarditis NOS Type 1 Excludes Type 1 Excludes Help A type 1 excludes note is a pure excludes. It means "not coded here". [icd10data.com]
Alterations in the myocardial extracellular matrix by matrix metalloproteinases and tissue inhibitors of metalloproteinases are critical during myocardial fibrosis and cardiac remodelling; however, the pathways that lead to progression to DCM are unclear [ecrjournal.com]
"For instance, the role of nuclear cardiology for assessing pericardial structures, myocardial fibrosis or valvular heart disease associated with RIHD is limited by its suboptimal spatial resolution," they wrote. [medicalphysicsweb.org]
Progressive fibrosis leads to impaired diastolic function, which can culminate in constrictive pericarditis (if the pericardial fibrosis dominates), restrictive cardiomyopathy (if the myocardial fibrosis dominates), or a combination of the 2 forms [ 6 [omicsonline.org]
Treatment
Lists the latest drugs used for the treatment of cardiopulmonary disorders. Includes information on laboratory medicine and pediatrics to help you apply cardiopulmonary principles to practice. [books.google.com]
Your heart will likely be checked before you start treatment. This will tell your doctor about your baseline (pre-treatment) heart health. [nccn.org]
Therefore, cardiologists recommend heart function be tested with an echocardiogram before treatment starts and again one year following treatment. [blog.dana-farber.org]
As more patients are surviving cancer and living longer, knowledge about the long-term effects of treatment is expanding. [my.clevelandclinic.org]
Prognosis
However, if damage to the heart muscle becomes chronic and/or progressive, the prognosis for the patient declines. Those who develop severely weakened heart muscle cardiomyopathy have a poorer prognosis. [rxlist.com]
Complications Congestive cardiac failure Pulmonary oedema Cardiogenic shock Dilated cardiomyopathy Dysrhythmias Recurrent myositis Prognosis The prognosis for patients with acute myocarditis can be very good but depends on clinical presentation, LVEF [patient.info]
Treatment of myocarditis The prognosis depends on the form of the disease and its severity. Myocarditis Abramov-Fiedler, septic and diphtheria myocarditis prognosis for life is poor. [qsota.com]
Etiology
Inflammation from viral etiologies is thought to be caused both by direct cellular damage by the infectious agent and also from involvement by the host's immune system. Etiology Infectious etiologies viral (most common etiology): e.g. [radiopaedia.org]
etiology triggered by ipilimumab as the most likely culprit of the heart failure," the researchers stated. [medpagetoday.com]
(See Etiology, Clinical, and Workup.) [emedicine.medscape.com]
Etiology Infectious Viral Most commonly implicated: Coxsackie B1-B5 ( picornavirus ), parvovirus B19, human herpesvirus 6 ( HHV-6 ), adenovirus, HCV, HIV, EBV, CMV, Echovirus, H1N1 influenza A Bacterial β-hemolytic Streptococcus group A (acute rheumatic [amboss.com]
Importantly, the clinical presentation, as well as the cardiac magnetic resonance findings, in our case were similar to those reported in other common etiologies of myocarditis, such as Parvovirus B19 infection. [revespcardiol.org]
Epidemiology
References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]
"As the epidemiological studies do not give clues on the important mechanisms underlying RIHD, it is difficult to design preventive strategies. [medicalphysicsweb.org]
Epidemiology The exact incidence of myocarditis is unknown. One study suggested that myocarditis is the cause of sudden cardiac death in 8.6% of cases and is identified in up to 9% of routine post-mortem examinations [ 1 ]. [patient.info]
[…] with nonirradiated patients, patients who have undergone chest radiotherapy have a 2% higher absolute risk of cardiac morbidity and death at 5 years and a 23% increased absolute risk after 20 years. 2 This article will review the pathophysiology and epidemiology [mdedge.com]
Pathophysiology
It integrates key concepts of pathophysiology, clinical manifestations, diagnostic tests and laboratory information and findings with clinically important medical and surgical interventions and pharmacologic therapies — then applies the material to physical [books.google.com]
The pathophysiology remains poorly understood, but radiation "might harm virtually all cardiac tissues and the underlying pathophysiological mechanisms may be related to micro- and macrovascular damages," they explained. [medicalphysicsweb.org]
But endothelial cells remain sensitive to radiation, and the pathophysiology of most forms of RIHD appears to be associated with damage to endothelial cells. [mdedge.com]
Few studies in animal models have explored the potential of molecular imaging to detect or monitor the effectors and/or modulators of inflammation based on the ability of radiolabeled ligands to measure pathophysiological processes. [ecrjournal.com]
Pathophysiology Dilated cardiomyopathy represents the final common morphologic outcome of various biologic insults. The combination of myocyte injury and necrosis associated with myocardial fibrosis results in impaired mechanical function. [clevelandclinicmeded.com]
Prevention
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]
Diphtheria myocarditis can be prevented by undergoing diphtheria immunization, and HIV can be prevented by following safe sex practices and avoiding intravenous drug use. [drugs.com]
Ultimately, the prevention of heart problems from cancer therapy is the goal. Here, too, there are signs of hope. In 2011, British researchers were able to prevent heart failure from trastuzumab (Herceptin) using beta blockers. [health.harvard.edu]
Prevention There's no specific prevention for myocarditis. However, taking these steps to prevent infections might help: Avoid people who have a viral or flu-like illness until they've recovered. [mayoclinic.org]
Prevention While it is difficult to prevent myocarditis, taking steps to prevent the spread of viral, bacterial and other types of infections may help to reduce the risk. [ada.com]