Myocarditis history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
The symptoms and the intensity of symptoms associated with myocarditis are variable. Patients may present with [[chest pain]] as a result of the inflammatory process involving the myocardium or with symptoms of [[congestive heart failure]]. | The symptoms and the intensity of symptoms associated with myocarditis are variable. 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== | ==History== | ||
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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 variable. 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
Myocarditis should be suspected in a patient with acute decompensation of cardiac function who is at low risk of ischemic heart disease.
A history of a recent (within the preceding 2-4 weeks) viral illness is often 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.