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Related Concept Videos

Myocarditis I: Introduction01:21

Myocarditis I: Introduction

28
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

20
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

15
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...
15
Myocarditis IV: Nursing Management01:22

Myocarditis IV: Nursing Management

26
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...
26
Introduction Cardiac Emergencies01:30

Introduction Cardiac Emergencies

46
Cardiac emergencies are critical situations involving the heart that require immediate medical intervention to prevent severe complications or death. These emergencies often arise from underlying heart conditions that impair the heart's ability to function correctly.Types of Cardiac EmergenciesThe most common types of cardiac emergencies include Acute Coronary Syndrome (ACS), myocardial infarction (MI), cardiac arrest, and heart failure.Acute Coronary Syndrome (ACS)Acute Coronary Syndrome (ACS)...
46
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

45
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Related Experiment Video

Updated: Sep 9, 2025

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Fever in Myocardial Infarction-Related Cardiogenic Shock.

Matthew Pierce1, Abduljabar Adi2, Rohit Jain3

  • 1Northwell Health, New Hyde Park, New York, USA; North Shore University Hospital, Manhasset, New York, USA.

JACC. Advances
|August 28, 2025
PubMed
Summary

Fever is common in acute myocardial infarction-related cardiogenic shock (AMI-CS) and indicates greater illness severity. However, most fever cases appear noninfectious, suggesting a need to optimize antibiotic use in these patients.

Keywords:
antibioticcardiogenic shockculturefeverinfectionmyocardial infarction

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Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • The role of fever in acute myocardial infarction-related cardiogenic shock (AMI-CS) is not well understood in current medical practice.
  • Understanding fever patterns and outcomes in AMI-CS is crucial for optimizing patient management.

Purpose of the Study:

  • To investigate the occurrence of fever in patients experiencing AMI-CS.
  • To analyze the impact of fever on clinical outcomes and treatment strategies in AMI-CS patients.

Main Methods:

  • A retrospective analysis of 1,372 patients in the Northwell-Shock registry diagnosed with AMI-CS.
  • Fever defined as ≥2 temperatures ≥38.0 °C or one ≥38.3 °C.
  • Comparison of characteristics, management, and outcomes between febrile and non-febrile AMI-CS patients.

Main Results:

  • Fever was observed in 40% of AMI-CS patients, typically appearing 2 days post-admission.
  • Febrile patients were younger, more male, exhibited higher shock severity, and received more invasive treatments, including antibiotics (84% vs 42%).
  • Despite increased antibiotic use, only 21% of febrile patients had positive microbial cultures. In-hospital mortality was similar, but febrile patients experienced longer hospital stays and more frequent discharges to skilled nursing facilities.

Conclusions:

  • Fever is a frequent occurrence in AMI-CS, correlating with increased illness severity.
  • The majority of fever cases in AMI-CS appear to be noninfectious in origin.
  • Further research is warranted to refine antibiotic stewardship and improve care for febrile AMI-CS patients.