UMEM Educational Pearls

Category: Cardiology

Title: myocarditis part I

Keywords: myocarditis (PubMed Search)

Posted: 5/27/2012 by Amal Mattu, MD (Updated: 12/4/2023)
Click here to contact Amal Mattu, MD

[pearl provided by Dr. Semhar Tewelde]

Myocarditis is an under-diagnosed cardiac disease resulting from a broad range of infectious, immune, and toxic etiologies

Symptoms range from asymptomatic, dyspnea (most commonly) and chest pain, to presentations with signs of myocardial infarction, pericardial effusion with cardiac tamponade, to devastating illness with cardiogenic shock
Etiologies to consider 
        Bacteria (tuberculosis, strep pneumonia, chlamydia, legionella, mycoplasma)
        Fungi (candida, aspergillosis, actinomyces, crypotococcus)
        Helminthic (trichinella, echinococcus)
        Protozoal (toxoplasma, trypanosoma)
        Viral (adeno, echo, parvo, entero e.g., coxsackie, HSV, CMV, EBV, HIV)
        Rickettsial (coxiellia,  rickettsia)
        Spirochetes (borrelia, treponema, leptospirosis) 
        Autoimmune diseases (celiac, churg-strauss, crohn's/UC, dermatomyositis, giant cell, 
        lupus, RA, sarcoidosis, kawasaki)
        Toxic reactions to drug (amphetamines, anthracyclines, catecholamines, cocaine, phenytoin)
        Others (ethanol, copper, iron, radiotherapy, thyroid storm)



Kindermann I, Barth C, Mahfoud F, et al. Update on Myocarditis. JACC:59;9 Feb 28, 2012.