emDocs - October 31, 2018 - Authors: Toni Riveros and Michael Schindlbeck
Edited by: Alex Koyfman and Brit Long
"Pearls & Pitfalls
- Myocarditis remains a challenging diagnosis given its wide range in clinical presentation, from a subtle picture of mild dyspnea and malaise following a recent viral illness to fulminant congestive heart failure and sudden cardiac death.
- Clinicians should investigate for clues including travel or immigration history, illicit drug use, underlying autoimmune conditions, transplant status, co-infections such as hepatitis or HIV, or treatment with chemotoxic or new antibiotic agents.
- Physical exam findings may include tachycardia disproportionate to body temperature, a toxic appearance without a clear source of infection, or dyspnea with signs of circulatory overload in a patient with no known cardiac history.
- Patients with myocarditis should be admitted to a setting capable of cardiac monitoring. Treatment in the ED is mainly supportive with careful attention to airway, breathing, and circulation."