Diagnosis and Management of Myocarditis: An Evidence-Based Review for the Emergency Medicine Clinician.

The Journal of Emergency Medicine
Michael GottliebBrit Long

Abstract

Myocarditis is a potentially fatal condition that can be misdiagnosed in the emergency department (ED) setting. The purpose of this narrative review article is to provide a summary of the background, pathophysiology, diagnosis, and management of myocarditis, with a focus on emergency clinicians. Myocarditis occurs when inflammation of the heart musculature causes cardiac dysfunction. Symptoms may range from mild to severe and are often preceded by a viral prodrome. Laboratory assessment and an electrocardiogram can be helpful for the diagnosis, but echocardiography is the ideal test in the ED setting. Some patients may also require advanced imaging, though this will often occur during hospitalization or follow-up. Treatment is primarily focused on respiratory and hemodynamic support. Initial hemodynamic management includes vasopressors and inotropes, whereas more severe cases may require an intra-aortic balloon pump, extracorporeal membrane oxygenation, or a ventricular assist device. Nonsteroidal anti-inflammatory drugs should be avoided while intravenous immunoglobulin is controversial. Myocarditis is a serious condition with the potential for significant morbidity and mortality. It is important for clinicians to be aware of ...Continue Reading

References

Jul 11, 1992·Journal of the American College of Cardiology·G W DecI Palacios
Dec 1, 1991·Journal of the American College of Cardiology·E B LiebermanK L Baughman
Feb 1, 1990·Clinical Pediatrics·S Press, R S Lipkind
Oct 19, 1989·The New England Journal of Medicine·J E ParrilloD Alling
Oct 1, 1989·Journal of the American College of Cardiology·L H ChowB M McManus
Jun 1, 1987·Journal of the American College of Cardiology·A MatsumoriW H Abelmann
Aug 1, 1988·The American Journal of Cardiology·B PinamontiF Camerini
Jun 1, 1987·Pediatric Emergency Care·W A Bonadio, J D Losek
Dec 1, 1986·Japanese Circulation Journal·S Wakafuji, R Okada
May 1, 1984·The American Journal of Cardiology·M S NieminenJ Karjalainen
Jan 6, 1983·The New England Journal of Medicine·J J FenoglioM B Weiss
Jul 15, 1995·The American Journal of Cardiology·W K ShenB J Gersh
Sep 1, 1994·Journal of the American College of Cardiology·R A FriedmanJ C Perry
Mar 1, 1997·The Journal of Emergency Medicine·J M Bergen, D C Smith
Nov 14, 1997·Journal of the American College of Cardiology·B LauerH P Schultheiss
Jan 5, 2000·The Annals of Thoracic Surgery·Y S ChenW J Ko
Jul 18, 2000·Journal of the American College of Cardiology·G M FelkerJ M Hare
Dec 31, 2000·Pediatric Cardiology·A W MountsJ Alexander
Jun 27, 2001·Journal of Cardiothoracic and Vascular Anesthesia·R O FeneckUNKNOWN European Milrinone Multicenter Trial Group
Aug 29, 2001·Circulation·P P Liu, J W Mason
May 10, 2002·Circulation Journal : Official Journal of the Japanese Circulation Society·Naoyoshi AoyamaUNKNOWN Japanese Investigators of Fulminant Myocarditis
Aug 22, 2002·Pediatric Cardiology·J-N WangJ-M Wu
Mar 26, 2003·Journal of the American College of Cardiology·G Michael FelkerUNKNOWN OPTIME-CHF Investigators
Apr 25, 2003·The New England Journal of Medicine·Steven E LipshultzSteven D Colan
Jun 7, 2003·Human Pathology·Sabine PankuweitBernhard Maisch
Oct 14, 2003·Clinical Pediatrics·Muhammad A KhanJayendra Sharma
Jan 30, 2004·The Medical Journal of Australia·Alessandra DoolanChristopher Semsarian
Aug 11, 2004·International Journal of Cardiology·Hae Soon KimJeong Wan Seo
Dec 8, 2004·Annals of Internal Medicine·Robert E EckartRenu Virmani
Jan 28, 2005·The Cochrane Database of Systematic Reviews·J RobinsonT P Klassen
Feb 2, 2006·Circulation·Kenneth L Baughman
Jan 24, 2007·American Journal of Epidemiology·Ville KytöPekka Saukko
Mar 28, 2007·Heart Failure Clinics·Fredric Ginsberg, Joseph E Parrillo

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Inflammation

Inflammation plays a significant role in the development of cardiovascular diseases, an understanding of these endogenous processes is critical for evaluating the risks and potential treatment strategies. Discover the latest research on cardiovascular inflammation here.

Artificial Heart & Ventricular Assist Devices

Total artificial hearts (TAH) and ventricular assist devices (VADs) provide cardiac support for patients with end-stage heart disease and have significantly improved the survival of these patients. Discover the latest research on Artificial Heart and Ventricular Assist Devices here.

Related Papers

Arthritis and Rheumatism
T W Bunch, R G Tancredi
Advances in Pediatrics
N A Drucker, J W Newburger
Bulletin de la Société internationale de chirurgie
O SAPHIR
The New England Journal of Medicine
Sebastian SzaboHans Martin Hoffmeister
The New England Journal of Medicine
W H Abelmann
© 2021 Meta ULC. All rights reserved