Myocarditis causes

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Myocarditis Microchapters


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S. Ogheneochuko Ajari, MB.BS, MS [2]


Life-threatening causes of myocarditis include carbon monoxide poisoning and Dengue fever. Common causes of myocarditis include bacterial infections, Lyme disease, and medications. Idiopathic myocarditis is the most common type of myocarditis and is often suspected to be secondary to a viral infection.[1]


Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.[2]

Common Causes

Causes by Organ System

Cardiovascular Adrenergic myocarditis, amyloidosis, Dressler syndrome, giant cell myocarditis, heart transplant, hemochromatosis, Kawasaki disease, peripartum cardiomyopathy, rheumatic fever
Chemical / poisoning Arsenic poisoning, arsenic trioxide, arsenicals, black widow spider envenomation, carbon monoxide poisoning, cobalt, copper, heavy metals, Insect bites (bee, wasp, spider, scorpion), lead poisoning, mercury, phosphorus, snake bite
Dermatologic Scleroderma, systemic lupus erythematosus
Drug Side Effect Amphetamines, anthracyclines, azithromycin, benzodiazepines, carbamazepine, catecholamines, cephalosporins, cerubidine, chloramphenicol, clozapine, cyclophosphamide, daunorubicin, dobutamine, doxorubicin, drug allergy, herceptin, interleukin-2, iron, lithium, loop diuretics, methydopate, methyldopa, methysergide, Olsalazine, penicillin, phenytoin, spironolactone, streptomycin, Sulfasalazine sulfonamides, thiazides, tricyclic antidepressants, Vaccinia (small pox vaccine)
Ear Nose Throat No underlying causes
Endocrine Amyloidosis, pheochromocytoma, thyrotoxicosis
Environmental Electrocution/lightning strike, heat stroke
Gastroenterologic Amebiasis, Celiac disease, Crohn's disease, hemochromatosis, ulcerative colitis
Genetic Celiac disease, Crohn's disease, Friedreich ataxia, hemochromatosis
Hematologic Hemochromatosis, hypereosinophilia
Iatrogenic Radiotherapy
Infectious Disease Actinomycosis, adenovirus, African trypanosomiasis, alveolar hydatid disease, amebiasis, arbovirus, ascariasis, aspergillosis, balantidiasis, bartonella, blastomycosis, borrelia burgdorferi, brucellosis, candida albicans, candidiasis, Chagas disease, chlamydia, cholera, clostridia, coccidioidomycosis, coxsackie B, cryptococcosis, cryptococcus neoformans, cysticercosis, cytomegalovirus, dengue, diphtheria, echinococcosis, echovirus, enterovirus, Epstein-Barr virus, filariasis, gonococcal, hemophilus influenzae, hepatitis B, hepatitis C, herpes simplex virus, heterophysiasis, histoplasmosis, HIV, human enterovirus B, infectious mononucleosis, influenza A, influenza B, legionella, leishmaniasis, leptospirosis, Lyme disease, malaria, melioidosis, meningococcal, mucormycosis, mumps, mycoplasma pneumoniae, neisseria meningitidis, nocardia, paragonimiasis, parvovirus B19, pneumococcal, poliomyelitis, psittacosis, Q fever, rabies, relapsing fever, respiratory syncytial virus, rheumatic fever, rickettsiae, rocky mountain spotted fever, rubella, rubeola, salmonella typhi, sarcosporidiosis, schistosomiasis, sleeping sickness (East African), sporotrichosis, staphylococci, streptococci, strongyloidiasis, syphilis, tetanus, toxoplasmosis, trichinella spiralis, trichinosis, tuberculosis, tularemia, typhus, varicella, variola, viral hepatitis, visceral larva migrans, yellow fever
Musculoskeletal / Ortho Rheumatoid arthritis
Neurologic Friedreich ataxia, poliomyelitis, tetanus
Nutritional / Metabolic Alcohol, amyloidosis, hemochromatosis
Obstetric/Gynecologic Peripartum cardiomyopathy
Oncologic Pheochromocytoma
Opthalmologic No underlying causes
Overdose / Toxicity Cocaine, doxorubicin, radiotherapy, eosinophilia myalgia syndrome
Psychiatric No underlying causes
Pulmonary Allergic bronchopulmonary aspergillosis, alveolar hydatid disease, aspergillosis, Churg-Strauss syndrome, sarcoidosis, scleroderma, tuberculosis, Wegener's granulomatosis
Renal / Electrolyte Wegener's granulomatosis
Rheum / Immune / Allergy Amyloidosis, Celiac disease, Churg-Strauss syndrome, Crohn's disease, eosinophilia myalgia syndrome, lupus, Reiter's syndrome, rheumatic fever, rheumatoid arthritis, sarcoidosis, scleroderma, systemic juvenile rheumatoid arthritis, systemic lupus erythematosus, Wegener's granulomatosis
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous Alcohol, heat stroke, hyperthermia, hypothermia

Causes in Alphabetical Order

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  1. Kühl U, Pauschinger M, Noutsias M, Seeberg B, Bock T, Lassner D; et al. (2005). "High prevalence of viral genomes and multiple viral infections in the myocardium of adults with "idiopathic" left ventricular dysfunction". Circulation. 111 (7): 887–93. doi:10.1161/01.CIR.0000155616.07901.35. PMID 15699250. Unknown parameter | ignored (help)
  2. Marques N, Gan VC, Leo YS (2013). "Dengue myocarditis in Singapore: two case reports". Infection. 41 (3): 709–14. doi:10.1007/s15010-012-0392-9. PMID 23277366. Unknown parameter | ignored (help)
  3. Centers for Disease Control and Prevention (CDC) (2013). "Three sudden cardiac deaths associated with Lyme carditis - United States, November 2012-July 2013". MMWR Morb Mortal Wkly Rep. 62 (49): 993–6. PMID 24336130. Unknown parameter | ignored (help)
  4. 4.0 4.1 4.2 4.3 Bowles NE, Ni J, Kearney DL, Pauschinger M, Schultheiss HP, McCarthy R; et al. (2003). "Detection of viruses in myocardial tissues by polymerase chain reaction. evidence of adenovirus as a common cause of myocarditis in children and adults". J Am Coll Cardiol. 42 (3): 466–72. PMID 12906974. Unknown parameter | ignored (help)
  5. Kühl U, Pauschinger M, Seeberg B, Lassner D, Noutsias M, Poller W; et al. (2005). "Viral persistence in the myocardium is associated with progressive cardiac dysfunction". Circulation. 112 (13): 1965–70. doi:10.1161/CIRCULATIONAHA.105.548156. PMID 16172268. Unknown parameter | ignored (help)
  6. 6.0 6.1 Roghi A, Pedrotti P, Milazzo A, Bonacina E, Bucciarelli-Ducci C (2011). "Adrenergic myocarditis in pheochromocytoma". J Cardiovasc Magn Reson. 13: 4. doi:10.1186/1532-429X-13-4. PMC 3025878. PMID 21223554. Unknown parameter | ignored (help)
  7. Pursnani A, Yee H, Slater W, Sarswat N (2009). "Hypersensitivity myocarditis associated with azithromycin exposure". Ann Intern Med. 150 (3): 225–6. PMID 19189924. Unknown parameter | ignored (help)
  8. Frustaci A, Cuoco L, Chimenti C, Pieroni M, Fioravanti G, Gentiloni N; et al. (2002). "Celiac disease associated with autoimmune myocarditis". Circulation. 105 (22): 2611–8. PMID 12045166.
  9. Haas SJ, Hill R, Krum H, Liew D, Tonkin A, Demos L; et al. (2007). "Clozapine-associated myocarditis: a review of 116 cases of suspected myocarditis associated with the use of clozapine in Australia during 1993-2003". Drug Saf. 30 (1): 47–57. PMID 17194170. Unknown parameter | ignored (help)
  10. Rose NR, Neumann DA, Herskowitz A (1992). "Coxsackievirus myocarditis". Adv Intern Med. 37: 411–29. PMID 1558005.
  11. Grist NR, Bell EJ (1969). "Coxsackie viruses and the heart". Am Heart J. 77 (3): 295–300. PMID 4887187.
  12. Cohen JI, Corey GR (1985). "Cytomegalovirus infection in the normal host". Medicine (Baltimore). 64 (2): 100–14. PMID 2983175.
  13. Spear GS (1995). "Eosinophilic explant carditis with eosinophilia: ?Hypersensitivity to dobutamine infusion". J Heart Lung Transplant. 14 (4): 755–60. PMID 7578186.
  14. Johnson MR (2004). "Eosinophilic myocarditis in the explanted hearts of cardiac transplant recipients: Interesting pathologic finding or pathophysiologic entity of clinical significance?". Crit Care Med. 32 (3): 888–90. PMID 15090985. Unknown parameter | ignored (help)
  15. Taliercio CP, Olney BA, Lie JT (1985). "Myocarditis related to drug hypersensitivity". Mayo Clin Proc. 60 (7): 463–8. PMID 4010343.
  16. Ben m'rad M, Leclerc-Mercier S, Blanche P, Franck N, Rozenberg F, Fulla Y; et al. (2009). "Drug-induced hypersensitivity syndrome: clinical and biologic disease patterns in 24 patients". Medicine (Baltimore). 88 (3): 131–40. doi:10.1097/MD.0b013e3181a4d1a1. PMID 19440116. Unknown parameter | ignored (help)
  17. Chimenti C, Russo A, Pieroni M, Calabrese F, Verardo R, Thiene G; et al. (2004). "Intramyocyte detection of Epstein-Barr virus genome by laser capture microdissection in patients with inflammatory cardiomyopathy". Circulation. 110 (23): 3534–9. doi:10.1161/01.CIR.0000148823.08092.0E. PMID 15557377. Unknown parameter | ignored (help)
  18. Cooper LT, Hare JM, Tazelaar HD, Edwards WD, Starling RC, Deng MC; et al. (2008). "Usefulness of immunosuppression for giant cell myocarditis". Am J Cardiol. 102 (11): 1535–9. doi:10.1016/j.amjcard.2008.07.041. PMC 2613862. PMID 19026310. Unknown parameter | ignored (help)
  19. Matsumori A, Yutani C, Ikeda Y, Kawai S, Sasayama S (2000). "Hepatitis C virus from the hearts of patients with myocarditis and cardiomyopathy". Lab Invest. 80 (7): 1137–42. PMID 10908160.
  20. Breinholt JP, Moulik M, Dreyer WJ, Denfield SW, Kim JJ, Jefferies JL; et al. (2010). "Viral epidemiologic shift in inflammatory heart disease: the increasing involvement of parvovirus B19 in the myocardium of pediatric cardiac transplant patients". J Heart Lung Transplant. 29 (7): 739–46. doi:10.1016/j.healun.2010.03.003. PMC 2902647. PMID 20456978. Unknown parameter | ignored (help)
  21. Pankuweit S, Moll R, Baandrup U, Portig I, Hufnagel G, Maisch B (2003). "Prevalence of the parvovirus B19 genome in endomyocardial biopsy specimens". Hum Pathol. 34 (5): 497–503. PMID 12792925. Unknown parameter | ignored (help)
  22. Cassimatis DC, Atwood JE, Engler RM, Linz PE, Grabenstein JD, Vernalis MN (2004). "Smallpox vaccination and myopericarditis: a clinical review". J Am Coll Cardiol. 43 (9): 1503–10. doi:10.1016/j.jacc.2003.11.053. PMID 15120802. Unknown parameter | ignored (help)