K H A L I D A L S U H A I B A N I

MYOCARDITIS

My supervisor:Dr. Ghous

OPJECTIVES:

• Define myocarditis.• Classify myocarditis.• Mention etiological factors of myocarditis.• Outline preventive measures and

management of myocarditis.

DEFINITION:

• It is diverse group of pathologic entities in which infectious microorganisms' and\or an inflammatory process cause myocardial injury.

CONT..

• Persistent inflammation, myocardial destruction, and adverse remodeling can lead to persistent ventricular dysfunction and dilated cardiomyopathy.• Asymptomatic. • Age groups: Any age group.• Most common in Children 1 -10 years.

PROBLEMS WITH MYOCARDITIS:

• Difficult to diagnose many cases missed and so its previously underappreciated role in sudden dysrhythmia death.• Morbidity and mortality data are difficult to

construct.

CONT.

• Most cases are viral but PCR needed for confirmation.• If these patients survive the first 3-4 weeks of

illness they have near 100% recovery and far fewer long-term complications compared with those patients with more indolent courses.

CLASSIFICATION OF MYOCARDITIS:

• Primary:Inflammation and myocyte damage without a clear etiologic agent.

• Secondary:• Myocarditis caused by HIV directly or by an

opportunistic pathogen.

ETIOLOGICAL FACTORS:

A- Infection:1- Viruses(E.g. Coxsackievirus, ECHO, Influenza, HIV, Cytomegalovirus)2- Bacteria Chlamydiae (e.g. C.psittaci), rickettsiae(e.g. R.typhi, typhus fever), Corynebacterium diphtheriae, Neisseria meningococcus, Borrelia (Lyme disease)

CONT.

3- Fungi• (e.g. candida)4- Parasite Protozoa• (E.g. trypanosoma cruzi "Chagas disease“(GIT),

toxoplamosis) Helmimths• (E.g. trichinosis)

CONT.

2- Immune-Mediated Reactions:• Postviral• Poststreptococcal (Rheumatic Fever)• Systemic Lupus Erythromatosus• Drug Hypersensitivity (E.g. methyldopa,

sulfonamides)• Transplant Rejection

CONT.

3- Unknown: • Sacoidosis• Giant cell myocarditis

PREVENTION:

• The condition does not have specific preventive measures, but almost all efforts are to preventing the occurrence of threatening infections:

1- Practicing good hygiene.2- Vaccinations for diphtheria and polio should be kept current.

CONT.

3- Avoid taking non prescribed drugs or even higher dosage of prescribed drugs by yourself.4- Prompt treatment of diseases that can lead to myocarditis may reduce the risk of developing this condition.

MANAGEMENT:

• Treatment of myocarditis depends on the cause and severity of condition.

1- Bed rest is essential, and avoids activates that increase cardiac workload.2- Administration of supplemental oxygen.3- Antipyretics, other than NSAIDs for fever and analgesics for pain .

CONT.

4- Patient with congestive heart failure treated by administration of sodium and fluids and diuretics, ACE inhibitors, β-blockers and spironolactone.5- Anticoagulants e.g. warfarin to prevent blood clots.6- Immunosuppressive therapy may be used if myocarditis is due to an autoimmune disorder such as lupus.

CONT.

7- If the cause is a bacterial infection, antibiotics are prescribed8- If it is viral, antiviral agents will be prescribed.9- For patients who have suffered severe damage to the heart, a heart transplant might be the only choice left.

SUMMARY

• Define myocarditis

• Classify myocarditis

REFERENCES

• Dr. nassima lect.• Robbins basis pathology

ANY QUESTIONs

THANK YOU