What is hemorrhagic pericarditis

Myocarditis

Abstract

Myocarditis can be caused as an inflammatory disease of the heart muscle tissue, infectious (especially viral) or non-infectious. It can be acute or chronic. Anamnestic should include a statement like "Since I had the flu, I always feel so limp and I am not really resilient!" think of myocarditis. Histopathologically, an inflammatory infiltration of the muscle tissue leads to the dissolution of the muscle cells (myocytolysis). With regard to the clinical symptoms as well as the examination results, the disease creates a colorful picture: the symptoms range from symptom-free healing to the occurrence of unspecific exhaustion (dizziness, weakness) and thoracic pain to fulminant courses with acute heart failure and threatening arrhythmias.

Fugitive ECG changes (e.g. arrhythmias or concave-shaped ST elevations) or increased laboratory heart enzymes can be detected diagnostically - more precise information is usually provided by imaging, especially cardio-MRI. If the findings are unclear, a myocardial biopsy may be necessary, although this is not completely risk-free as an interventional procedure. When planning therapy, the main focus is on symptomatic treatment with physical rest and inpatient monitoring in order to be able to identify and treat threatening complications such as cardiac arrhythmias and decompensated cardiac insufficiency at an early stage. Depending on the genesis, causal therapy is also possible, e.g. antibiotics for bacterial myocarditis.

Epidemiology

  • Exact incidence unclear
    • It is estimated that 1-5% of all viral infections are associated with cardiac involvement
    • Frequent incidental finding in autopsies of young people who suddenly died (approx. 10%)

Unless otherwise stated, the epidemiological data refer to Germany.

etiology

Infectious

Non-infectious

Symptoms / clinic

The clinical symptoms of myocarditis are unspecific and very heterogeneous - they range from asymptomatic to fulminant courses!

Gradient and special forms

Myocarditis

  • Fulminant
  • Acute
  • Chronically active
  • Chronically persistent

Pericarditis

Diagnosis

Clinical examination

EKG / long-term EKG

Analogous to the clinical symptoms, a very different and possibly temporary ECG manifestation is possible.

laboratory

Imaging