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Potentially life-threatening emergency
Myocarditis
Other Resources UpToDate PubMed
Potentially life-threatening emergency

Myocarditis

Contributors: Michael W. Winter MD, Tarun Tandon MD, Ryan Hoefen MD, PhD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Myocarditis is a disease characterized by inflammation of the myocardium caused by an underlying noninfectious or infectious etiology. Viral infections are more likely to cause myocarditis than bacterial, fungal, or protozoal infections. Noninfectious causes are typically autoimmune, including giant cell myocarditis and celiac disease, although a wide range of systemic diseases have been associated with myocarditis. Several inherited cardiomyopathies have been identified (ie, arrhythmogenic right ventricular dysplasia, Fabry disease). Toxic exposures can also lead to myocarditis. Immune checkpoint inhibitors, used to treat a variety of cancers, have emerged as a significant and likely underestimated cause of myocarditis. Other drug associations include antipsychotic medications, cytotoxic drugs, salicylates, and vaccinations against smallpox, anthrax, influenza, and, rarely, COVID-19.

Presentations can be acute, subacute, or chronic, presenting with focal or diffuse involvement of the myocardium.

Presenting symptoms can be highly variable. They can include chest pain, shortness of breath, presyncope, syncope, or sudden cardiac death. Subacute myocarditis can present with subtle symptoms including fatigue, weight loss, or dyspnea on exertion. These symptoms can be acute or subacute.

Some patients will experience complete resolution of myocardial inflammation and subsequent injury, while others will have residual cardiac dysfunction with manifestations of congestive heart failure.

Diagnosis and treatment of the underlying cause is key to the management of myocarditis; treatment otherwise is generally supportive.

Codes

ICD10CM:
I51.4 – Myocarditis, unspecified

SNOMEDCT:
50920009 – Myocarditis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:02/03/2019
Last Updated:11/01/2022
Copyright © 2023 VisualDx®. All rights reserved.
Potentially life-threatening emergency
Myocarditis
A medical illustration showing key findings of Myocarditis : Chest pain, Fatigue, Heart palpitations, HR increased, Pre-syncope, Dyspnea on exertion
Copyright © 2023 VisualDx®. All rights reserved.