Myocarditis is inflammation of the heart muscle (myocardium), leading to myocyte (heart cell) damage and dysfunction.
Mnemonic: "M.Y.O. = Muscle of Your Organ (Heart) Infected"
CAUSES OF
MYOCARDITIS
• Viral Infections (Most Common – Coxsackievirus B, Adenovirus,
Influenza, HIV).
• Bacterial Infections (Diphtheria, Tuberculosis, Lyme Disease).
• Fungal Infections (Aspergillus, Candida).
• Parasitic Infections (Trypanosoma cruzi – Chagas Disease).
• Autoimmune Diseases (SLE, Rheumatic Fever, Sarcoidosis).
• Toxins (Alcohol, Cocaine, Chemotherapy – Doxorubicin).
Mnemonic: "V.B.F.P.A.T." (Virus, Bacteria, Fungi, Parasites, Autoimmune, Toxins)
PATHOGENESIS OF
MYOCARDITIS
1. Infection
→ Virus enters heart cells → Direct damage.
2. Immune Response
→ Body attacks virus but also damages heart cells.
3. Inflammation
→ Weakens heart muscle → Leads to heart failure or arrhythmias.
Mnemonic: "I.I.I." (Infection → Immune Response → Inflammation)
SYMPTOMS OF
MYOCARDITIS
-Early Symptoms (Like Viral Flu):
- Fever, Malaise, Fatigue, Muscle Aches (Myalgia).
- Sore Throat, Cough, Nausea, Vomiting.
• Cardiac Symptoms (Due to Heart Inflammation):
- Chest Pain (Often Pleuritic – Worse on Deep Breathing).
- Palpitations, Irregular Heartbeat (Arrhythmias).
- Breathlessness (Heart Failure Symptoms).
- Swelling in Legs (If Severe).
Mnemonic: "F.C.P.B.S." (Fever, Chest Pain, Palpitations, Breathlessness, Swelling)
CLINICAL SIGNS OF
MYOCARDITIS
- Tachycardia (Fast Heartbeat) – Out of Proportion to Fever.
- Low Blood Pressure (If Severe).
- Heart Murmurs (If Valves Involved).
- Pericardial Rub (If Pericardium is Inflamed).
Mnemonic: "T.L.H.P." (Tachycardia, Low BP, Heart Murmur, Pericardial Rub)
DIAGNOSIS OF
MYOCARDITIS
Blood Tests:
- High ESR, CRP (Inflammation Markers).
- Raised Cardiac Enzymes (CPK-MB,
Troponin).
ECG:
- ST-T Changes, Arrhythmias, Heart
Block.
Chest X-ray:
- Mild Cardiomegaly, Pulmonary
Congestion.
Echocardiography (Best Test!):
- Shows Weak Heart Contraction, Dilated
Ventricles.
Endomyocardial Biopsy (Definitive Test, But Rarely Done).
Mnemonic: "B.E.C.E." (Blood, ECG, CXR, Echo – Best Test)
TREATMENT OF
MYOCARDITIS
1. GENERAL
MANAGEMENT
- Bed Rest (Reduce Heart Workload).
- Monitor in ICU (If Severe Arrhythmias).
- Avoid Heavy Exercise (Can Worsen Condition).
Mnemonic: "B.M.A." (Bed Rest, Monitor, Avoid Exercise)
2. MEDICAL
TREATMENT
- Diuretics (For Fluid Overload & Breathlessness).
- Beta-Blockers (Control Heart Rate & Prevent Arrhythmias).
- ACE Inhibitors (Improve Heart Function).
- Antiviral Drugs (For Viral Causes, If Available).
Mnemonic: "D.B.A.A." (Diuretics, Beta-Blockers, ACEI, Antivirals)
3.
IMMUNOSUPPRESSIVE THERAPY (In Autoimmune Myocarditis)
- Steroids (Only in Severe Autoimmune Cases – Controversial).
COMPLICATIONS OF
MYOCARDITIS
• Dilated Cardiomyopathy (DCM) – Weak Heart Muscle.
• Heart Failure (Pump Failure, Fluid Accumulation).
• Arrhythmias (Irregular Heartbeats – Can Cause Sudden Death).
• Pericarditis (Inflammation of Heart Covering).
Mnemonic: "D.H.A.P." (DCM, Heart Failure, Arrhythmias, Pericarditis)
PREVENTION OF
MYOCARDITIS
- Vaccination (For Preventable Viral Infections – Influenza, Hepatitis, Polio).
- Early Treatment of Infections (Especially Strep Throat, TB).
- Avoid Alcohol & Drug Abuse (Prevent Toxin-Induced Myocarditis).
Mnemonic: "V.E.A." (Vaccination, Early Treatment, Avoid Toxins)
FINAL REVISION WITH MNEMONICS
- Definition = "M.Y.O. = Muscle of Your Organ (Heart) Infected"
- Causes = "V.B.F.P.A.T." (Virus, Bacteria, Fungi, Parasites, Autoimmune, Toxins)
- Pathophysiology = "I.I.I." (Infection → Immune Response → Inflammation)
- Symptoms = "F.C.P.B.S." (Fever, Chest Pain, Palpitations, Breathlessness, Swelling)
- Signs = "T.L.H.P." (Tachycardia, Low BP, Heart Murmur, Pericardial Rub)
- Diagnosis = "B.E.C.E." (Blood, ECG, CXR, Echo – Best Test)
- Treatment = "B.M.A." (Bed Rest, Monitor, Avoid Exercise) & "D.B.A.A." (Diuretics, Beta-Blockers, ACEI, Antivirals)
- Complications = "D.H.A.P." (DCM, Heart Failure, Arrhythmias, Pericarditis)
- Prevention = "V.E.A." (Vaccination, Early Treatment, Avoid Toxins)