Discussion Author(s): Primary author: Jason Messinger
Contributing author: Eric Jones
Myocarditis is an inflammation of the myocardium, which can lead to necrosis and myocyte degeneration. Because of it often presents with angina, acute myocarditis may be misdiagnosed as acute myocardial infarction.
Myocarditis is a condition that presents with a range of symptoms ranging from chest pain and mild dyspnea to sudden cardiac death. Often times the angina associated with myocarditis is accompanied with ECG abnormalities like ST elevation and atrial or ventricular arrhythmias. Ways of diagnosing myocarditis include clinical presentation and electrocardiograms, echocardiography, cardiac MRI, chest x-rays, endomyocardial byposy, or laboratory work-ups. Studies have concluded that good markers include viral-induced myocarditis are cardiac troponins.
The population most affected by this disease is young male adults. The incidence of myocarditis is reported as varying somewhere between 0.12% and 12%. Because this condition is associated with other cardiomypoathies there is an increased risk for complications that can be fatal. Myocarditis is often more severe in newborns and infants and usually presents with nonspecific symptoms.
The most common etiology of myocarditis is viral-induced infections, notably the parvovirus B-19 and human herpesvirus-6. Bacterial infections are not as common in producing myocarditis. Treatment of the condition depends on the etiology. Dilated cardiomyopathy with heart failure is a long-term result if left untreated.
Treatment varies among patients with myocarditis depending on the severity of their symptoms and chronicity.
Treatments for acute myocarditis depend on the patientâ€™s symptoms and include antiviral regimens, nonsteroidal antinflammatory drugs, mechanical circulatory and transplant, immunosuppressive treatment, intravenous immunoglobulin, antiarrhythmic treatment, and physical activity. Prognosis for patients with acute myocarditis is excellent if they present with mild symptoms and have a preserved left ventricular ejection fraction.
Patients with chronic sequelae of myocarditis can develop dilated cardiomyopathy and preferred treatment is supportive therapy.
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