Myocarditis
Myocarditis may be due to:
·
Infections: viral, e.g. coxsackie B, EBV.
·
Kawasaki
disease.
·
Drugs: adriamycin.
·
Connective tissue disease: SLE; rheumatoid arthritis;
rheumatic fever; sarcoidosis.
Variable and will depend on the
age of the patient and on the time course of underlying disease. Specific
cardiovascular symptoms include progres-sive worsening of dyspnoea and
congestive cardiac failure. Sudden onset of ventricular arrhythmia may occur.
Typical cardiovascular examination
includes:
·
weak
pulses;
·
tachycardia;
·
gallop
heart rhythm;
·
distant
heart sounds.
Echocardiography shows poor
ventricular function. Definitive histological diagnosis is made after
percutaneous endomyocardial biopsy. CXR shows cardiomegaly; ECG shows reduced
QRS complex size.
This is directed at the underlying
cause and at controlling symptoms of congestive heart failure. Arrhythmias
should be treated. Cardiac transplan-tation is needed in patients with
refractory heart failure.
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