(NEJM 2001;344:857)
Definition
• Inflammatory process of heart muscle, caused by viruses (coxsackie, enterovirus, adenovirus), Chagas dz, meds (cocaine, lithium, doxorubicin), allergic rxn, SLE, scleroderma
History
• Fever, arthralgia, malaise, DOE
Findings
• Varies: Asymptomatic, e/o heart failure, cardiogenic shock
Evaluation
• ECG: Ventricular arrhythmia, heart block, Δs of pericarditis (see above)
• CXR: ↑ cardiac size
• Labs: ↑ CK/cardiac enzymes, eosinophilia, ESR
Treatment
• Largely supportive. Treat CHF & cardiogenic shock.
Pearl
• Dx is based largely on high clinical suspicion, esp in absence of other etiologies for new onset CHF. There is no diagnostic gold standard.