Our patient presented with cardiocirculatory shock, necessitating the use of inotropes and mechanical ventilation. [ncbi.nlm.nih.gov]

Our patient presented with cardio-circulatory shock, necessitating the use of inotropes and mechanical ventilation. [link.springer.com]

The clinical presentation of myocarditis is usually variable. Affected patients typically present with a broad spectrum of signs and symptoms ranging from subclinical to cardiogenic shock, arrhythmia, and even sudden death. [synapse.koreamed.org]

Myocarditis : clinical presentation and management Maarten Groenink, MD, PhD Dept. [textbookofcardiology.org]

• Congestive Heart Failure

  A 66-year-old woman presented with new-onset complete left bundle branch block and congestive heart failure. [ncbi.nlm.nih.gov]

  Cases of myocarditis may vary from complete healing (with or without significant scarring), to severe congestive heart failure leading to death or requiring a heart transplant. [encyclopedia.com]

  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]

  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]

• Heart Disease

  They include: rheumatic heart disease, congenital heart disease (i.e., bicuspid aortic valve, ventricular septal defect, coarctation of the aorta, tetralogy of Fallot), mitral valve prolapse, degenerative heart disease (e.g., calcific aortic valve disease [atsu.edu]

  Atrial fibrillation is a common manifestation of hypertensive heart disease. Hypertensive heart disease is the leading identifiable cause of heart failure in older women. [clevelandclinicmeded.com]

  Hypertensive heart disease — High blood pressure resulting in a disease of the heart. Ischemic heart disease — Insufficient blood supply to the heart muscle (myocardium). [encyclopedia.com]

  Heart Inflammatory heart disease Infective myocarditis Topic Completed: 1 May 2014 Revised: 25 February 2019 Copyright: 2014-2019, PathologyOutlines.com, Inc. [pathologyoutlines.com]

  Ongoing disease may be because of persistent virus in the heart or to immunopathic attack. Depending on the cause, treatment may be antiviral or immunosuppressive. [journals.lww.com]

• Cardiomegaly

  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]

  […] supraventricular and ventricular arrhythmias can occur in patients with myocarditis The presence of Q waves or a new left bundle branch block (LBBB) are associated with higher rates of cardiac death or heart transplantation Radiology description Chest Xray: cardiomegaly [pathologyoutlines.com]

  The chest radiograph is variable, ranging from normal to cardiomegaly with or without pulmonary vascular congestion and edema. [textbookofcardiology.org]

  Myocarditis should be suspected when shock is accompanied by cardiomegaly or pulmonary edema. A number of metabolic and genetic diseases are associated with cardiomyopathy, and may cause similar signs and symptoms of myocardial dysfunction. [clinicaladvisor.com]

  Diagnostic Modalities The chest x-ray typically demonstrates cardiomegaly and increased pulmonary vascular markings, indicating pulmonary oedema. [jpma.org.pk]

• Gallop Rhythm

  All patients presented with tachypnoea, tachycardia, sweating, gallop rhythm, pulmonary wheezing, rales and hepatomegaly. [bestbets.org]

  Heart sounds - soft S1 or S4 gallop rhythm. Signs of heart failure. Aetiology Infection Viral infection is the most common cause of acute myocarditis [ 2 ]. [patient.info]

  A gallop rhythm, produced by the third or fourth heart sound is best heard at the apex. [jpma.org.pk]

  Auscultation of the heart for heart murmurs, friction rubs, gallops, and irregular rhythms together with the signs and symptoms mentioned above help make the diagnosis of rheumatic heart disease more likely. [atsu.edu]

  Examination should focus on whether the heart is palpably dilated, the presence of murmurs, and additional heart sounds (gallops). [clevelandclinicmeded.com]

• Heart Murmur

  In severe cases, symptoms include breathlessness, rapid pulse, and heart arrhythmias. In infants, symptoms may also include bluish skin, heart murmurs, and a poor appetite. [healthcentral.com]

  Nearly all patients will have an audible heart murmur. Although classically described as a changing murmur the murmur usually does not change significantly over time unless a valve leaflet is destroyed or a chordae tendineae ruptures. [atsu.edu]

• Systolic Murmur

  Cardiogenic shock in fulminant cases Auscultation findings Brief systolic murmurs Heart failure → S3 (and S4) gallops Pericarditis → pericardial friction rub The clinical manifestation of myocarditis is very heterogenous and nonspecific, ranging from [amboss.com]

• Bone Pain

  Chest pain, typically behind the sternum ( breast bone pain ) Palpitations Rapid and/or irregular heart rate Fever (infectious and sometimes immune-mediated causes) Shortness of breath Fatigue Leg swelling Additional symptoms may be related to the underlying [healthhype.com]

(See Etiology, Clinical, and Workup.) [emedicine.medscape.com]

• Rickettsia Typhi

  typhi (typhus fever) Fungi like Candida Protozoa Trypanosoma cruzi (Chagas disease) Toxoplasmosis Helminths like trichinosis Immune In these instances the body’s immune system targets the heart muscle and causes inflammation due to one or more trigger [healthhype.com]

• Coxiella Burnetii

  Evidence of endocardial involvement by positive echocardiogram OR new regurgitant murmur Positive Q fever serology (antiphase I IgG > 1:800), or single blood culture positive for Coxiella burnetii Predisposing heart disease or injection drug use Fever [atsu.edu]

Supportive therapy is paramount in the treatment of this condition. [ncbi.nlm.nih.gov]

Treatment The treatment goal is to relieve symptoms of heart failure and there is no effective proven treatment for myocarditis. Usually medications for heart failure are recommended. [nhcs.com.sg]

Depending on the cause, treatment may be antiviral or immunosuppressive. Endomyocardial biopsy is proving of value in determining cause and deciding future therapy. [journals.lww.com]

Treatment [ edit ] Treatment of myocarditis differs between cases, and depends on the severity of each condition. [en.wikibooks.org]

In spite of the multitude of advances in definition, diagnosis and treatment, this may still be the most effective treatment. [healthcentral.com]

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. [medicinenet.com]

Anecdotal evidence suggests an excellent long term prognosis. Links: myocarditis [gpnotebook.co.uk]

In amyloidosis and hypertrophic cardiomyopathy, myocarditis may affect prognosis. [textbookofcardiology.org]

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]

Each chapter includes eight to ten gross and microscopic photographs with legends highlighting the pathologic features of the disease, as well as succinct text covering etiology, clinical aspects, and differential diagnosis. [books.google.de]

(See Etiology, Clinical, and Workup.) [emedicine.medscape.com]

Causes of myocarditis Even though a broad spectrum of etiologies has been implicated as causes of myocarditis, viral myocarditis still represents the prototype for the study of this disease and its evolution. [news-medical.net]

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]

Therefore, the concurrent viral etiology of intussusceptions and myocarditis in this child might explain the presence of two distinct diseases in autopsy. [synapse.koreamed.org]

Seite 69 - Epidemiology is defined as the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control of health problems. ‎ [books.google.de]

References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. [amboss.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]

[…] was first introduced by Corvisart It is defined by WHO / International Society and Federation of Cardiology (ISFC) as an inflammatory disease of the heart muscle, diagnosed by established histological, immunological and immunohistochemical criteria Epidemiology [pathologyoutlines.com]

Epidemiology Forced exercise, pregnancy, use of steroids or nonsteroidal anti-inflammatory agents, use of ethanol, and nutritional deficiencies are factors that predispose a patient to symptomatic myocarditis. [atsu.edu]

[…] criteria Epidemiology Postmortem data identify myocarditis in 8.6% to 12% of cases of sudden death in young adults The Myocarditis Treatment Trial reported the incidence of biopsy proven myocarditis in patients with unexplained heart failure to be 9.6% Pathophysiology [pathologyoutlines.com]

Further studies of the pathophysiology of myocarditis would lead to improved diagnostic criteria, which would facilitate future research. Read the full abstract... Background: This is an update of a previous review. [cochrane.org]

Journal Circulation 115:5-8 (2007) DOI: 10.1161/CIRCULATIONAHA.106.670554 Reference PMID: 12439638 Authors Pankuweit S, Portig I, Maisch B Title Pathophysiology of cardiac inflammation: molecular mechanisms. [genome.jp]

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]

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]

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]

Deterrence and prevention Vaccination should reduce the incidence of myocarditis caused by measles, rubella, mumps, poliomyelitis, and influenza. The development of vaccines for other cardiotropic viruses may prevent viral myocarditis in the future. [emedicine.medscape.com]

Prevention Although myocarditis is an unpredictable disease, the following measures may help prevent its onset. Individuals should: Take extra measures to avoid infections, and obtain appropriate treatment for infections. [encyclopedia.com]