MYOCARDITIS

Inflammation of the myocardium that may progress to chronic dilated CMP, is most commonly related to acute viral infection (e.g., coxsackievirus, adenovirus, Epstein-Barr virus, parvovirus B19, human herpesvirus 6). Myocarditis may also develop in pts with HIV infection, hepatitis C, or Lyme disease. Chagas’ disease (Trypanosoma cruzi) is a common cause of myocarditis in endemic areas, typically Central and South America. Noninfective causes of myocarditis include granulomatous disease (e.g., sarcoidosis, giant cell myocarditis), which should be considered if VT or conduction blocks dominate the presentation of heart failure in the absence of CAD. Rare etiologies include eosinophil myocarditis, hypersensitivity myocarditis, and systemic inflammatory diseases (e.g., polymyositis, dermatomyositis).

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