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Related Concept Videos

Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

346
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
346
Myocarditis IV: Nursing Management01:22

Myocarditis IV: Nursing Management

400
Myocarditis is an inflammatory condition of the myocardium requiring meticulous nursing management for optimal patient outcomes. Effective management begins with a thorough assessment of the patient's medical history, paying close attention to past infections, autoimmune disorders, travel history, and exposure to toxins or drugs. Recent viral infections and systemic diseases are particularly relevant due to their potential role in triggering myocarditis.Physical Examination and MonitoringThe...
400
Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

595
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
595
Myocarditis I: Introduction01:21

Myocarditis I: Introduction

647
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
647
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

497
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
497
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

390
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
390

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Related Experiment Videos

Corticosteroids for viral myocarditis.

Huai Sheng Chen1, Wei Wang, Sheng Nan Wu

  • 1Intensive Care Unit, Shenzhen People's Hospital, The Second Affiliated Hospital of Ji Nan University, 1017 Dong Men Bei Lu, Luo Hu District, Shenzhen City, Guangdong, China, 518020.

The Cochrane Database of Systematic Reviews
|October 19, 2013
PubMed
Summary

Corticosteroids do not reduce mortality in viral myocarditis patients with low ejection fraction. While potentially improving cardiac function, evidence is limited by low-quality, small trials, necessitating further research on efficacy and adverse events.

Related Experiment Videos

Area of Science:

  • Cardiology
  • Immunology
  • Infectious Diseases

Background:

  • Myocarditis, characterized by myocardial inflammation and necrosis, may involve autoimmune responses post-viral infection.
  • The efficacy and safety of corticosteroid treatment for viral myocarditis remain subjects of ongoing debate.
  • This review updates existing evidence on corticosteroid use in viral myocarditis management.

Purpose of the Study:

  • To assess the benefits and harms of corticosteroid treatment for acute or chronic viral myocarditis.
  • To determine optimal corticosteroid dosage regimens for viral myocarditis.

Main Methods:

  • Comprehensive literature search across multiple databases (CENTRAL, MEDLINE, EMBASE, BIOSIS, Web of Science, LILACS, Chinese Biomed, CNKI, WANFANG) up to December 2012.
  • Inclusion of randomized controlled trials (RCTs) comparing corticosteroids with placebo, supportive care, or other therapies.
  • Independent data extraction by two reviewers, with results presented as risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs).

Main Results:

  • Eight small, low-quality RCTs with 719 participants were included.
  • Corticosteroids did not significantly reduce mortality (RR 0.93, 95% CI 0.70 to 1.24).
  • Potential improvement in left ventricular ejection fraction (LVEF) was observed (MD 7.36%, 95% CI 4.94 to 9.79), particularly in pediatric subgroups, but with substantial heterogeneity. Reductions in creatine phosphokinase (CPK) and creatine kinase-MB (CKMB) were noted, with limited data on adverse events.

Conclusions:

  • Corticosteroids do not appear to reduce mortality in viral myocarditis patients with low LVEF.
  • Observed improvements in cardiac function (LVEF) are uncertain due to the low quality and small size of included trials.
  • High-quality, large-scale RCTs are needed to definitively establish the role of corticosteroids in viral myocarditis, with careful evaluation of adverse events.