Myocarditis

62

Myocarditis

Graham Jackson
London Bridge Hospital, London, UK
Heart Metab. (2014) 62:2

  • Myocarditis presenting acutely is an inflammatory disease of the myocardium. The estimated incidence varies from 3 to 6% and a diagnosis is made difficult by the fact that myocarditis often presents subclinically and unexpectedly. It may well be a cause of sudden unexplained cardiac death, particularly in young people. While the principal etiology in developed countries is viral, the underlying cause may not easily be identified. Dr Kühl addresses the issue in detail in his article. Clinically, if a patient presents with a sudden onset of symptoms of chest pain or heart failure with or without arrhythmias, and when other causes have been excluded, myocarditis must always be considered, particularly if there is coexistent viral illness, for example influenza [1]. Alternatively, the patient may have been taking drugs that are known to be linked to hypersensitivity reactions, for example penicillin. There are no specific points in the examination of the patient, but there may well be signs of heart failure. The collection of physical signs and patient symptoms, combined with chest pain or the presentation of dyspnea that is not recognized to be reflecting ischemic heart disease, should alert the physician to the possibility of myocarditis as an etidogy. Drs Cooper and El Amm elegantly discuss the management of myocarditis that takes these parameters on board. Importantly, they widen the differential diagnosis so that treatment can be precisely targeted at the cause [2]. read more…

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