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Sarcoid Myocarditis

Myocarditis Sarcoid (etiology)


Presentation

  • We describe a patient presenting with a ventricular tachycardia, presumably originating in the right ventricle (RV).[ncbi.nlm.nih.gov]
  • Three cases of sudden death occurring in systemic sarcoidosis with myocardial involvement are presented.[ncbi.nlm.nih.gov]
  • Presentation with heart failure predicted IGCM, and presentation with heart block or more than nine weeks of symptoms predicted CS.[onlinejacc.org]
  • The most common presentations in GCM patients were heart failure and AV-block.[myocarditisfoundation.org]
Hunting
  • Hunt, J. M. Vidal, and W. J. Esber; Mid America Heart Institute, Kansas City, Missouri: D. R. Bresnahan, N. D. Long, and R. T. O’Kell; Newark Beth Israel Medical Center, Newark, New Jersey: M. J. Zuker and L. T.[onlinejacc.org]
  • Hunt SA, Abraham WT, Chin MH, et al.[clevelandclinicmeded.com]
  • A ‘red flag’ is the dilated RV with normal or supranormal function which should precipitate a shunt hunt - Qp:Qs analysis, pulmonary vein and interatrial septum interrogation.[jcmr-online.biomedcentral.com]
Cardiac Signs and Symptoms
  • The diagnosis of CS may be easy if cardiac signs or symptoms develop in a patient with a known diagnosis of extra-cardiac disease, but is particularly challenging in isolated CS.[escardio.org]
Meningism
  • Ferri’s popular "5 books in 1" format provides quick guidance on short QT syndrome, microscopic polyangiitis, fungal meningitis, and much more. This medical reference makes the answers you need even easier to find - anytime, anywhere.[books.google.de]
  • Similar Codes ICD-10 Code ICD-10 Description D86 Sarcoidosis D86.0 Sarcoidosis of lung D86.1 Sarcoidosis of lymph nodes D86.2 Sarcoidosis of lung with sarcoidosis of lymph nodes D86.3 Sarcoidosis of skin D86.8 Sarcoidosis of other sites D86.81 Sarcoid meningitis[healthprovidersdata.com]
  • […] immunodeficiency virus [HIV] disease ( B20 ) D86 Sarcoidosis D86.0 Sarcoidosis of lung D86.1 Sarcoidosis of lymph nodes D86.2 Sarcoidosis of lung with sarcoidosis of lymph nodes D86.3 Sarcoidosis of skin D86.8 Sarcoidosis of other sites D86.81 Sarcoid meningitis[icd10coded.com]
  • D86.85 ICD-10-CM Codes Adjacent To D86.85 D86 Sarcoidosis D86.0 Sarcoidosis of lung D86.1 Sarcoidosis of lymph nodes D86.2 Sarcoidosis of lung with sarcoidosis of lymph nodes D86.3 Sarcoidosis of skin D86.8 Sarcoidosis of other sites D86.81 Sarcoid meningitis[icd10data.com]
  • It includes meningeal inflammation or infiltration, hypothalamic-pituitary effects (for example, diabetes insipidus), encephalopathy, vasculopathy, seizures, aseptic meningitis, hydrocephalus, and mass lesions.[es.slideshare.net]

Workup

ST Elevation
  • Diagnostic clues: Signs of CHF, possibly a pericardial friction rub, EKG showing nonspecific ST changes and sometimes low voltages (due to myocardial edema), sometimes signs of pericarditis (i.e. diffuse ST elevations), and can have frank ST elevations[errolozdalga.com]
  • Eosinophilic myocarditis is further distinguished from non-eosinophilic myocarditis by having a different set of causes and recommended treatments. [14] [15] Diagnosis [ edit ] Diffuse ST elevation in a young male due to myocarditis and pericarditis Myocarditis[en.wikipedia.org]
Lymphocytic Infiltrate
  • Lymphocyte infiltration and myocyte necrosis are histological findings. Dallas criteria are used for the histological diagnosis of myocarditis. [1,3] Echocardiography Echocardiogram can roughly locate the site of inflammation.[explainmedicine.com]
  • infiltration Endomyocardial biopsy Eosinophilic infiltration Necrotizing eosinophilic myocarditis Eosinophilic myocarditis Virtual slides Images hosted on other servers: Sarcoidosis Positive stains CD3 T lymphocytes, CD68 histiocytes Back to top[pathologyoutlines.com]
  • Myocarditis identified at autopsy or on endomyocardial biopsy in HIV-infected patients is most often nonspecific and manifests as focal, inflammatory lymphocytic infiltrates without myocyte necrosis.[intechopen.com]

Treatment

  • Not everyone who has the disease needs treatment. If you do, prednisone, a type of steroid, is the main treatment.[icdlist.com]
  • Prior data concerning epidemiology, outcome with contemporary treatment and ICDs, and the effect of novel diagnostic methods is scarce and I set out to study these questions.[myocarditisfoundation.org]
  • This latest revision presents updated clinical information and has eight new chapters, including obesity and metabolic syndrome, women and heart disease, and heart failure treatment.[books.google.com]
  • Saying no to the procedure hasn't seemed to affect anything in my treatment.[inspire.com]
  • Take advantage of expanded coverage of small molecule treatment, biologics, biomarkers, epigenetics, biosimilars, and cell-based therapies.[books.google.de]

Prognosis

  • In majority of cases, lung sarcoidosis is a self-limiting disease whereas cardiac involvement carries a poorer prognosis due to heart failure and malignant arrhythmias.[myocarditisfoundation.org]
  • The prognosis of patients with nonischemic cardiomyopathy is partly dependent on the histologic diagnosis (1) .[onlinejacc.org]
  • For both of them the dismal prognosis can be improved by early diagnosis and tailored immunosuppressive therapy.[escardio.org]
  • Prognosis and Therapy: 1) Lymphocytic (Viral) Myocarditis – prognosis is variable, but many patients will spontaneously recover. The benefit of immunosuppression and IVIG is unclear, again since many patients recover on their own.[errolozdalga.com]
  • The prognosis of patients with subclinical cardiac sarcoidosis is controversial.[consultqd.clevelandclinic.org]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • Cardiac sarcoidosis (CS) is a multisystem granulomatous disorder of unknown etiology with frequent cardiac involvement. We describe a patient presenting with a ventricular tachycardia, presumably originating in the right ventricle (RV).[ncbi.nlm.nih.gov]
  • VL - 21 IS - 1 N2 - Cardiac sarcoidosis (CS) is a multisystem granulomatous disorder of unknown etiology with frequent cardiac involvement.[unboundmedicine.com]
  • Conclusion: Myocardial gene expression profiling is emerging as yet another powerful tool to: 1) reach an etiological diagnosis and subsequent etiology-direct therapy, 2) reach differential diagnosis of IGCM, CS and lymphocytic myocarditis, 3) get an[escardio.org]
  • Coronary angiogram has a role mainly in ruling out ischemia as an etiology. Cardiac MRI is being used more and more and is good at detecting myocardial damage and edema which can point you towards myocarditis.[errolozdalga.com]

Epidemiology

  • Prior data concerning epidemiology, outcome with contemporary treatment and ICDs, and the effect of novel diagnostic methods is scarce and I set out to study these questions.[myocarditisfoundation.org]
  • The cellular infiltrate contains lymphocytes, histiocytes, and collections of eosinophils (arrowheads) (hematoxylin and eosin, x400) Epidemiology and Demographics Giant cell myocarditis often affects young otherwise healthy individuals.[wikidoc.org]
  • […] eosinophilic and giant cell myocarditis (GCM) Terminology GCM has been termed idiopathic GCM, pernicious myocarditis, Fiedler myocarditis, acute idiopathic interstitial myocarditis, giant cell granulomatous myocarditis, and granulomatous myocarditis Epidemiology[pathologyoutlines.com]
  • 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]
  • Epidemiology of sarcoidosis : recent advances and future prospects. Semin Respir Crit Care Med 2007; 28:22–35. 5. Song Z, Marzilli L, Greenlee BM, et al.[journals.lww.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Data from a Lewis Rat model and from observational human studies suggest that giant cell myocarditis is mediated by T lymphocytes. The disease may therefore respond to treatment aimed at attenuating T cell function.[wikidoc.org]
  • […] myocarditis, Fiedler myocarditis, acute idiopathic interstitial myocarditis, giant cell granulomatous myocarditis, and granulomatous myocarditis Epidemiology Incidence difficult to determine as most cases are believed to be subclinical or underdiagnosed Pathophysiology[pathologyoutlines.com]
  • Myocarditis, defined as inflammatory disease of the myocardium, has a first phase of direct or indirect tissue damage due to infection, followed by an autoimmune phase. 3 Corticosteroids would thus be expected to affect the pathophysiological process.[elsevier.pt]
  • Our observation that CS and IGCM have distinct natural histories suggests that they may also be pathophysiologically distinct.[onlinejacc.org]
  • 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

  • Treatable - 0% Emergent - ED Care Needed - Preventable/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary[medicbind.com]
  • 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.de]
  • Pagina 487 - Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures. Recommendations of the Immunization Practices Advisory Committee (ACIP). ‎[books.google.it]
  • […] and Atkins KA described that in developed countries infectious causes of heart muscle inflammation are uncommon in immunocompetent individuals. [3] Patients with Acquired immunodeficiency syndrome ( AIDS ) , transplant associated immunosupression to prevent[ispub.com]
  • This may provide a minimally invasive approach to preventing adverse remodeling after MI. a large multicenter series of heart failure patients.[kundoc.com]

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