Myocarditis
Basics
Description
Description
- An inflammatory infiltrate of the myocardium with necrosis or degeneration of myocytes not typical of ischemic changes. Direct cytotoxic effect of causative agent followed by a secondary immune response
- True incidence is unknown because many cases are asymptomatic
- Autopsy studies have demonstrated evidence of myocarditis in 1–7% of cases and >50% in HIV patients
- Male > female (1.5:1)
- Average age of patients with myocarditis is 42 yr
- Major cause of unexpected sudden death (15–20% of cases) <40 yr old
Etiology
Etiology
- Viral:
- Enteroviruses (coxsackie B)
- Adenovirus
- Parvovirus B19
- Herpesvirus (including cytomegalovirus [CMV])
- Herpes virus 6
- Hepatitis C
- Influenza
- Echovirus
- Herpes simplex virus
- Varicella-zoster
- Epstein–Barr virus
- Cytomegalovirus
- Mumps
- Rubeola
- Variola/vaccinia
- Yellow fever
- Rabies
- HIV
- Bacteria:
- Diphtheria
- Tuberculosis
- Brucellosis
- Psittacosis
- Meningococcus
- Mycoplasma
- Group A streptococcus
- Protozoa:
- Leishmaniasis
- Malaria
- Toxoplasmosis in the immunocompromised host
- Treponema cruzi (Chagas disease):
- Most common cause of heart failure and myocarditis worldwide
- 20 million persons infected in Central and South America
- Trichinosis
- Trypanosomiasis
- Spirochetes:
- Borrelia burgdorferi, the spirochete agent in Lyme disease
- Syphilis
- Rickettsial:
- Scrub typhus
- Rocky Mountain spotted fever
- Q fever
- Fungal:
- Candidiasis
- Aspergillosis
- Cryptococcosis
- Histoplasmosis
- Actinomycosis
- Helminthic
- Trichinosis
- Echinococcosis
- Schistosomiasis
- Cysticercosis
- Drugs:
- Acetaminophen
- Ampicillin
- Chemotherapeutic agents (anthracyclines)
- Cocaine
- Hydrochlorothiazide
- Lithium
- Methyldopa
- Penicillin
- Sulfamethoxazole
- Sulfonamides
- Zidovudine
- Radiation
- Hypersensitivity
- Heavy metals
- Hydrocarbons
- Carbon monoxide
- Arsenic
- Autoimmune disorders:
- Systemic lupus erythematosus (SLE)
- Wegener granulomatosis
- Kawasaki disease
- Giant cell arteritis
- Sarcoidosis
- Peripartum cardiomyopathy
- Bites/stings:
- Scorpion
- Snake
- Black widow venom
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Citation
Schaider, Jeffrey J., et al., editors. "Myocarditis." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307186/all/Myocarditis.
Myocarditis. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307186/all/Myocarditis. Accessed December 1, 2024.
Myocarditis. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307186/all/Myocarditis
Myocarditis [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 01]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307186/all/Myocarditis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Myocarditis
ID - 307186
ED - Barkin,Adam Z,
ED - Shayne,Philip,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307186/all/Myocarditis
PB - Lippincott Williams & Wilkins
ET - 6
DB - Emergency Central
DP - Unbound Medicine
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