Patients with myocarditis, alternatively with ICMP, have heterogenous inconveniences and symptoms. In up to 60 % of cases, the disease is most commonly preceded by a viral infection of the gastrointestinal or respiratory system. In children, previous increased physical or psychological load is often documented [24, 43, 99, 100, 101]. Signs of the disease are chest pain, nausea, dyspnoea, fever, flu-like symptoms, arthralgia and myalgia, rash (in hypersensitive reaction), peripheral oedema, palpitation, and syncope [43, 96, 99, 100]. In children, the absence of appetite, abdominal pain, vomiting and in severe cases cyanosis may occur [101, 102]. In myocarditis with the development of heart failure, heart failure-related symptoms may be observed – increased jugular vein volume, hepatomegaly, ascites etc. Even supraventricular and ventricular arrhythmias are not an exception [24, 100].
Physical examination findings may be even normal or poor [8]. Besides the above-mentioned symptoms, even tachypnoea, tachycardia, worse tangible peripheral pulsation, thromboembolic symptoms, symptoms related to systematic disease (which are associated with myocarditis) may be found. During stethoscope examination, mitral valve murmur, pericardial or pleural murmur, pulmonary murmurs, and others may be present [43].
Author of the opening picture: Johannes Jansson
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References:
8) ZEMÁNEK D. Kapitola 15: Zánětlivé onemocnění myokardu. In: VESELKA, J. a V.ROHN. Kardiovaskulární medicína [online]. 1. vydání. Brno: Fasta Medica, 2015. ISBN 978-80-88056-00-3.
24) CAFORIO, A.L.P, PANKUWEIT S., ARBUSTINI E., et al. Current state knowledge on aetiology, diagnosis, management, and Therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Disease. European Heart Journal. 2013, 34(-), 2636–2648.
43) M, HOLICKÁ a ŠPINAR J. Myokarditidy. ACTA MEDICINAE. 2013, 2013(7), 68-74.
99) KUCHYNKA, P. a et al. Myokarditida a zánětlivá kardiomyopatie. Kapitoly z kardiologie. 2013, 3(-), 87-91.
100) KREJČÍ, J. Myokarditidy a zánětlivé kardiomyopatie. Kardiologická Revue Interní Medicína. 2015, 17(4), 288-294.
101) TOMEK, V. Kapitola 56: Myokarditidy. In: CHALOUPECKÝ, V. a et al. Dětská kardiologie. Praha: Galén, 2006. pp. 327-329. ISBN 80-7262-406-5.
102) STARÁ, V. Nestrukturální srdeční onemocnění u dětí. Vox Pediatriae. 2006, 6(4), 26-32.
