Myocarditis 5 Principles of Myocarditis: 1. Build clinical suspicion 2. Decide on EMBx 3. Manage acute cardiac injury 4. Manage chronic cardiac sequelae 5. Treat myocarditis Clinical Presentation: - Fever, Rash, Myalgias, Fatigue, Resp/Gl sx Fulminant: - Acute HF, Cardiogenic shock, Arrythmias, Pericarditis, Tamponade EKG Findings: - AV block, Aberrancy, VT/VF, Myocardial injury (ST elevation), Low voltage Treatment: - Lymphocytic Myocarditis: role of steroids +/- azathioprine unclear - Giant Cell Myocarditis: steroids, calcineurin inhibitor, anti-metabolite - Immune Checkpoint Inhibitors: cessation of inciting therapy, steroids, ARB/sacubitril-valsartan, PPM placement - Necrotizing Eosinophilic Myocarditis: identify precipitating agent, steroids, AC CardioNerds Podcast @cardionerds #Myocarditis #diagnosis #management #cardiology #summary #biopsy
