Myocarditis
40,955views
00:00 / 00:00
Flashcards
Myocarditis
of complete
Questions
USMLE® Step 1 style questions USMLE
of complete
Image reproduced from CDC.gov
External References
First Aid
2024
2023
2022
2021
Autoimmune diseases
myocarditis p. 477
Myocarditis p. 477
adenovirus p. 161
Corynebacterium diphtheriae p. , 137
coxsackievirus p. 164
diptheria p. 137
picornaviruses p. 164
Toxocara canis p. , 156
Tachycardia
with myocarditis p. 477
Transcript
With myocarditis, myo- means muscle, card- means heart, and -itis means inflammation. So, myocarditis is inflammation of the myocardium, which is the muscular middle layer of the heart wall, which contracts and relaxes so the heart can pump blood all around the body.
Inflammation in the myocardium layer causes swelling, which damages the heart muscle cells’ ability to contract. That means that less blood gets pumped out of the heart with each heartbeat. If myocarditis is severe enough, it can lead to heart failure, which is when the heart can’t keep up with the demands of the body. Once the inflammation resolves, the heart contraction typically returns to normal, but occasionally, when the inflammation is really severe, it can cause fibrosis, or scar tissue, in the myocardium. Scar tissue doesn’t contract normally, so if that happens, it can cause long term problems with heart contraction.
In North America, viral infections, specifically Coxsackievirus B infections, are the main cause of myocarditis. Viral infections can trigger lymphocytic myocarditis, which is when lymphocytes - the B and T cells of the immune system - and water make their way into the interstitial space - the space in between heart muscle cells. There are plenty of other infectious causes as well, though. One of these is trypanosoma cruzi, a single-cell protozoan that causes Chagas disease throughout South America. In Chagas disease, under a microscope, it’s possible to see groups of amastigotes within the heart muscle cells, which are trypanosomes that are in the intracellular stage. As a result, the heart muscle cells necrose or die. There’s also Trichinella, a roundworm that moves from the intestines into various parts of the body, causing a variety of problems, including myocarditis. Myocarditis can also be seen in Lyme disease which is caused by the bacteria Borrelia burgdorferi, which is spread by deer ticks. Finally, in immunocompromised individuals, there’s Toxoplasma gondii, a single-cell parasite harbored by cats, that can cause myocarditis.
Summary
Myocarditis is an inflammation of the heart muscle, also known as the myocardium. It can be caused by a variety of different infections, including viruses, bacteria, fungi, and parasites. It can also be caused by autoimmune diseases, such as lupus, or by drugs and toxins. Symptoms of myocarditis include chest pain, palpitations, shortness of breath, and fluid retention which might be an indication of heart failure. Treatment for myocarditis involves medications to reduce inflammation, and antibiotics to treat any underlying infections. In some cases, a heart transplant may be necessary.
Sources
- "Pediatric nonviral myocarditis" Medscape (2015)
- "Myocarditis overview" Life in the Fastlane (2017)
- "Treatment and prognosis of myocarditis in adults" UpToDate (2017)
- "Robbins Basic Pathology (10 edition)" Elsevier (2017)
- "First Aid for the USMLE Step 1 2017 (27 edition)" McGraw-Hill Education / Medical (2017)
- "Beta blockers and heart failure." Trinity Student Medical Journal 2003 (2003)
- "Myocarditis" Texas Heart Institute (2017)
- "Myocarditis" Wikipedia.
- "Fundamentals of Pathology: Medical Course and Step 1 Review" Pathoma LLC (2017)
- "Myocarditis: practice essentials" Medscape (2016)
- "Myocarditis pathology" Medscape (2015)