Myocarditis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief:: Varun Kumar, M.B.B.S.
Overview
The symptoms and the intensity of symptoms associated with myocarditis are vary. Patients may present with chest pain as a result of the inflammatory process involving the myocardium or with symptoms of congestive heart failure. patients may complain of palpitations, a racing heart or syncope. In fulminant myocarditis, patients present with the abrupt onset of flu-like symptoms and the abrupt onset of heart failure symptoms. In chronic and acute myocarditis, the onset of symptoms may be more insidious.
History
Patients present with acute decompensation of cardiac function in patients with low cardiac risk or no obvious underlying cause. Demographics and clinical course should be taken into consideration in diagnosis of myocarditis.
A history of recent (2-4 weeks) viral illness may often be elicited in a large number of patients with myocarditis. Cardiac specific symptoms may become apparent usually in the subacute virus-clearing phase.
In hypersensitive myocarditis, patients may give a history of using offending drug.
Symptoms
Symptoms of myocarditis include:[1]
- Chest pain is often described as stabbing, pleuritic or sharp in character. In a series, 78% of patients were diagnosed with myocarditis when they presented with chest pain[2].
- Pedal edema in volume overload states.
- Breathlessness
- Dyspnea on exertion
- Orthopnea in pulmonary congestion.
- Palpitations
- Syncope in setting of high grade AV block
- Fever (especially when infectious, e.g. in rheumatic fever)
- Joint pains, and fatigue as seen in viral illness.
- Cynosis may also be seen in severe cases.
- Sudden death (in young adults, myocarditis causes up to 20% of all cases of sudden death)[3]. This probably can be attributed to ventricular tachycardia or fibrillation.
References
- ↑ Feldman AM, McNamara D. Myocarditis. N Engl J Med 2000;343:1388-98. PMID 11070105.
- ↑ Sarda L, Colin P, Boccara F, Daou D, Lebtahi R, Faraggi M; et al. (2001). "Myocarditis in patients with clinical presentation of myocardial infarction and normal coronary angiograms". J Am Coll Cardiol. 37 (3): 786–92. PMID 11693753.
- ↑ Eckart RE, Scoville SL, Campbell CL, Shry EA, Stajduhar KC, Potter RN, Pearse LA, Virmani R. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med 2004;141:829-34. PMID 15583223.