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Related Concept Videos

Myocarditis I: Introduction01:21

Myocarditis I: Introduction

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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...
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Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

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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...
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Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

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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...
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Myocarditis IV: Nursing Management01:22

Myocarditis IV: Nursing Management

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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...
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

37
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

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Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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Eosinophilic myocarditis: systematic review.

Witina Techasatian1, Maan Gozun1, Kristine Vo1

  • 1Department of Medicine, UH Mānoa JABSOM, Honolulu, Hawaii, USA.

Heart (British Cardiac Society)
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PubMed
Summary

Eosinophilic myocarditis (EM) diagnosis often omits endomyocardial biopsy (EMB). Cardiac MRI (CMR) shows promise as an alternative diagnostic tool, though treatment consensus for EM remains elusive.

Keywords:
magnetic resonance imagingmyocarditissystematic reviews as topic

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Area of Science:

  • Cardiology
  • Immunology
  • Pathology

Background:

  • Eosinophilic myocarditis (EM) is a rare but serious cardiac condition.
  • Guidelines recommend endomyocardial biopsy (EMB) for diagnosis, but it is often forgone in clinical practice.
  • Alternative diagnostic methods are needed to improve EM detection and management.

Approach:

  • A systematic review of peer-reviewed articles was conducted using MEDLINE and EMBASE databases.
  • Search terms included 'eosinophilic myocarditis' from inception to September 10, 2022.
  • The review analyzed 239 articles, encompassing 8 observational studies and 274 patient cases.

Key Points:

  • EMB confirmed diagnosis in 82.4% of cases; 17.6% were diagnosed using clinical reasoning and cardiac MRI (CMR).
  • CMR-diagnosed patients presented with better cardiac function (higher ejection fraction) and less need for circulatory support.
  • Idiopathic causes and eosinophilic granulomatosis with polyangiitis were the most frequent etiologies of EM.

Conclusions:

  • Endomyocardial biopsy (EMB) remains the gold standard for diagnosing eosinophilic myocarditis (EM).
  • Cardiac MRI (CMR) may serve as a valuable screening tool in specific clinical situations.
  • Further research, including large clinical trials, is needed to establish optimal CMR utility and corticosteroid treatment regimens for EM.