Causes and Management of Myocarditis

Author: Celia Bagshaw / Editors: Jason M Kendall / Reviewer: Stewart H McMorran, Emma Everitt / Codes: A1 / Published: 05/02/2021

Description:

Myocarditis is an uncommon disease but it has a significant morbidity and mortality. This session describes the presentation, causes and treatment of myocarditis, which play a key role in the prevention of a missed or delayed diagnosis of a patient with this potentially fatal disease.

After completing this session you will be able to:

  • Recognise the importance of myocarditis as an uncommon but potentially fatal cardiac disease
  • Explain the basic pathophysiology and the broad range of causative agents
  • Describe the variety of presenting symptoms and signs of the disease and the differential diagnoses
  • Plan a diagnostic strategy within the emergency department (ED)
  • Explain how to commence the management of myocarditis within the ED

References:

  1. MASON, J. et al. (1995) A Clinical Trial of Immunosuppressive Therapy for Myocarditis. The New England Journal of Medicine, 333, pp. 269-275.
  2. FABRE, A. and SHEPPARD, M.N. (2006) Sudden adult death syndrome and other non-ischaemic causes of sudden cardiac death. Heart, 92, pp. 316-320.
  3. BRADY, W. et al. (2004) Myocarditis: emergency department recognition and management. Emergency medicine clinics of North America, 22, pp. 865-885.
  4. KARJALAINEN, J. et al. (1983) Etiology of mild acute infectious myocarditis: relation to clinical features. Acta Med Scand, 213, pp. 65-73.
  5. FELMAM, A. AND MCNAMARA (2000) Myocarditis. The New England Journal of Medicine, 343, pp. 1388-1399.
  6. MAGNANI, J. and DEC, W. (2006) Myocarditis: Current Trends in Diagnosis and Treatment. Circulation, 113, pp. 876-890.
  7. SMITH, S. et al. (1997) Elevations of Cardiac Troponin I Associated with Myocarditis. Circulation, 95, pp. 163-168.
  8. CHEN, H., LUI, J. and YANG, M. Corticosteroids for viral myocarditis (Cochrane review). In: The Cochrane Library, Issue 4. Chichester: Wiley, 2006.
  9. ROBINSON, J. et al. Cochrane Database of Systematic Reviews (Cochrane review). In: The Cochrane Library, Issue 1. Chichester: Wiley, 2006.
  10. DAMBROSIO, A. et al. (2001) The fate of acute myocarditis between spontaneous improvement and evolution to dilated cardiomyopathy: a review. Heart, 85, pp. 499-504.

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