Myocarditis causes

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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] Homa Najafi, M.D.[3]


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.


Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.[1]

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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Disease name] may be caused by [cause1], [cause2], or [cause3].


Common causes of [disease] include [cause1], [cause2], and [cause3].


The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].


The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.


Life-threatening Causes

  • Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. There are no life-threatening causes of disease name, however complications resulting from untreated disease name is common.
  • Life-threatening causes of [symptom/manifestation] include [cause1], [cause2], and [cause3].
  • [Cause] is a life-threatening cause of [disease].

Common Causes

Common causes of [disease name] may include:

  • [Cause1]
  • [Cause2]
  • [Cause3]


  • [Disease name] is caused by an infection with [pathogen name].
  • [Pathogen name] is caused by [pathogen name].

Less Common Causes

Less common causes of [disease name] include:

  • [Cause1]
  • [Cause2]
  • [Cause3]

Genetic Causes

  • [Disease name] is caused by a mutation in the [gene name] gene.

Causes of myocarditis:[22][23][24][25][26][27][28][29][30]

Immune-mediated myocarditis
-Tetanus toxoid


-Serum sickness












-Thiazide diuretics

Heart transplant rejection
-Infection-negative lymphocytic

-Infection-negative giant cell
Autoimmune disorders:


-Rheumatoid arthritis

-Churg-Strauss syndrome

-Kawasaki's disease




-Myasthenia gravis

-DM type1



-Wegener's granulomatosis

-Rheumatic heart disease

Toxic myocarditis
Heavy metals
Physical agents















-Electric shock
-Scorpion sting

-Snake, and spider bites

- Bee and wasp stings

-Carbon monoxide




-Sodium azide

Infectious myocarditis






-Corynebacterium diphtheriae

-Haemophilus influenzae

-Mycobacterium tuberculosis

-Mycoplasma pneumonia

-Borrelia -Leptospira
- Aspergillus









-Trypanosoma cruzi

-Toxoplasma gondii


-Trichinella spiralis

-Echinococcus granulosus

-Taenia solium
-Coxiella burnetii





-Influenza A & B viruses


-Mumps virus

-Measles virus

-Rubella virus

-Hepatitis C virus

-Dengue virus

-Yellow fever virus



-Paravirus B19







  1. 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)
  2. 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)
  3. 3.0 3.1 3.2 3.3 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)
  4. 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)
  5. 5.0 5.1 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)
  6. 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)
  7. 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.
  8. 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)
  9. Rose NR, Neumann DA, Herskowitz A (1992). "Coxsackievirus myocarditis". Adv Intern Med. 37: 411–29. PMID 1558005.
  10. Grist NR, Bell EJ (1969). "Coxsackie viruses and the heart". Am Heart J. 77 (3): 295–300. PMID 4887187.
  11. Cohen JI, Corey GR (1985). "Cytomegalovirus infection in the normal host". Medicine (Baltimore). 64 (2): 100–14. PMID 2983175.
  12. Spear GS (1995). "Eosinophilic explant carditis with eosinophilia: ?Hypersensitivity to dobutamine infusion". J Heart Lung Transplant. 14 (4): 755–60. PMID 7578186.
  13. 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)
  14. Taliercio CP, Olney BA, Lie JT (1985). "Myocarditis related to drug hypersensitivity". Mayo Clin Proc. 60 (7): 463–8. PMID 4010343.
  15. 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)
  16. 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)
  17. 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)
  18. 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.
  19. 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)
  20. 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)
  21. 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)
  22. "Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of Cardiomyopathies". Circulation. 93 (5): 841–842. 1996. doi:10.1161/01.CIR.93.5.841. ISSN 0009-7322.
  23. Leone, Ornella; Veinot, John P.; Angelini, Annalisa; Baandrup, Ulrik T.; Basso, Cristina; Berry, Gerald; Bruneval, Patrick; Burke, Margaret; Butany, Jagdish; Calabrese, Fiorella; d'Amati, Giulia; Edwards, William D.; Fallon, John T.; Fishbein, Michael C.; Gallagher, Patrick J.; Halushka, Marc K.; McManus, Bruce; Pucci, Angela; Rodriguez, E. René; Saffitz, Jeffrey E.; Sheppard, Mary N.; Steenbergen, Charles; Stone, James R.; Tan, Carmela; Thiene, Gaetano; van der Wal, Allard C.; Winters, Gayle L. (2012). "2011 Consensus statement on endomyocardial biopsy from the Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology". Cardiovascular Pathology. 21 (4): 245–274. doi:10.1016/j.carpath.2011.10.001. ISSN 1054-8807.
  24. Kindermann, Ingrid; Barth, Christine; Mahfoud, Felix; Ukena, Christian; Lenski, Matthias; Yilmaz, Ali; Klingel, Karin; Kandolf, Reinhard; Sechtem, Udo; Cooper, Leslie T.; Böhm, Michael (2012). "Update on Myocarditis". Journal of the American College of Cardiology. 59 (9): 779–792. doi:10.1016/j.jacc.2011.09.074. ISSN 0735-1097.
  25. Sagar, Sandeep; Liu, Peter P; Cooper, Leslie T (2012). "Myocarditis". The Lancet. 379 (9817): 738–747. doi:10.1016/S0140-6736(11)60648-X. ISSN 0140-6736.
  26. Dennert, R.; Crijns, H. J.; Heymans, S. (2008). "Acute viral myocarditis". European Heart Journal. 29 (17): 2073–2082. doi:10.1093/eurheartj/ehn296. ISSN 0195-668X.
  27. Maron, Barry J.; Towbin, Jeffrey A.; Thiene, Gaetano; Antzelevitch, Charles; Corrado, Domenico; Arnett, Donna; Moss, Arthur J.; Seidman, Christine E.; Young, James B. (2006). "Contemporary Definitions and Classification of the Cardiomyopathies". Circulation. 113 (14): 1807–1816. doi:10.1161/CIRCULATIONAHA.106.174287. ISSN 0009-7322.
  28. Bock, Claus-Thomas; Klingel, Karin; Kandolf, Reinhard (2010). "Human Parvovirus B19–Associated Myocarditis". New England Journal of Medicine. 362 (13): 1248–1249. doi:10.1056/NEJMc0911362. ISSN 0028-4793.
  29. P. Liu, T. Martino, M. A. Opavsky & J. Penninger (1996). "Viral myocarditis: balance between viral infection and immune response". The Canadian journal of cardiology. 12 (10): 935–943. PMID 9191484. Unknown parameter |month= ignored (help)
  30. Cambridge, G; MacArthur, C G; Waterson, A P; Goodwin, J F; Oakley, C M (1979). "Antibodies to Coxsackie B viruses in congestive cardiomyopathy". Heart. 41 (6): 692–696. doi:10.1136/hrt.41.6.692. ISSN 1355-6037.

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