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Internal Medicine
6. Myocarditis
Learning objectives: at the end of this lesson the student will be able to:
1. Define Myocarditis. .
2. List the etiologies of Myocarditis.
3. Describe the different types of Myocarditis.
4. Understand the epidemiology of Myocarditis.
5. Understand the pathophysiology of Myocarditis.
6. Identify the clinical manifestation of Myocarditis.
7. Identity consequences of Myocarditis.
8. Understand the diagnostic approach of Myocarditis.
9. Understand the principle of management of Myocarditis.
Definition: Myocarditis is inflammation of the myocardium often resulting from infectious
process, which subsequently leads to myocardial destruction and a dilated cardiomyopathy.
The acute picture is nonspecific unless overt congestive heart failure develops. Although the
causes of myocarditis are numerous, the most common association is an antecedent viral
Etiologies of Myocarditis
1. Infectious causes
Viral infections : Coxsackievirus B , HIV myocarditis ( overt involvement is seen
in 10 % of HIV patients )
Bacterial myocarditis:
Not common usually occurs as a complication of infective endocarditis.
Diphtheric myocarditis may develop in ¼ of patients with diphtheria
Fungal myocarditis
Protozoal myocarditis: Chaga’s disease caused by a protozoon Trypanosoma
cruzi and transmitted by an insect vector. It is one of the most common causes of
heart disease in Central and South America.
Rickettsial myocarditis :associated with Typhus , Lyme disease
Spirocheatal myocarditis: associated with Relapsing fever.