Myocarditis

Background

• Inflammation of the myocardium
• Can be acute or chronic, leading to eventual cardiomyopathy

Etiology

• Infectious
  • Viral
    • Parvovirus B19
    • HHV-6
    • Coxsackie virus A and B
    • Influenza virus A and B
    • Hepatitis B virus
    • Hepatitis C virus
    • In developing countries: mumps, rubella, dengue, chikungunya, polio, Ebola, yellow fever
  • Bacterial
    • Corynebacterium diphtheriae
    • Borrelia
    • In developing countries: Trypanosoma cruzi, Trypanosoma brucei gambiense, Trichinella spiralis
• Non-infectious
  • Connective tissue disorders
  • Inflammatory or infiltrative diseases
  • Hypersensitivity reactions
  • Toxins
  • Endocrinopathies
  • Radiation
• Immunocompromised hosts
  • Viral: HIV, CMV, EBV, VZV, adenovirus, parvovirus B19
  • Fungal: Candida, Cryptococcus
  • Parasitic: Toxoplasma gondii, Trypanosoma cruzi

Clinical Manifestations

• Fever, fatigue, malaise, chest pain, dyspnea, palpitations
• Friction rub if concomitant pericarditis

Diagnosis

• Endomyocardial biopsy