Myocarditis physical examination

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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.

Physical Examination

General appearance

Patients with mild cases of myocarditis may have a nontoxic appearance or simply may appear to have a viral syndrome. Patients with acute onset may present with signs of cardiac dysfunction.

Vital signs

• Hypotension (in left ventricular systolic dysfunction)
• Tachycardia
• Fever (infective cause)

Cardiac examination

• Jugular venous distension may be noted if the patient has cardiac dysfunction or failure
• Apical impulse may be displaced laterally which would be suggestive of enlargement of ventricles.
• Auscultation:
  • S₃ or occasionally summation gallop may be noted, particularly in significant biventricular dysfunction.
  • Tachycardia
  • Mitral or tricuspid murmurs (holosystolic murmurs) may also be noted in the presence of significant ventricular dilation leading to regurgitant flow across AV valves.