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Myocarditis is most often due to a viral infection. [1] Other causes include bacterial infections, certain medications, toxins and autoimmune disorders. [1] [2] A diagnosis may be supported by an electrocardiogram (ECG), increased troponin, heart MRI, and occasionally a heart biopsy.
Viral cardiomyopathy occurs when viral infections cause myocarditis with a resulting thickening of the myocardium and dilation of the ventricles. These viruses include Coxsackie B and adenovirus, echoviruses, influenza H1N1, Epstein–Barr virus, rubella (German measles virus), varicella (chickenpox virus), mumps, measles, parvoviruses, yellow fever, dengue fever, polio, rabies, and the ...
A complete blood count may show an elevated white count and a serum C-reactive protein may be elevated. Acute pericarditis is associated with a modest increase in serum creatine kinase MB (CK-MB). [ 5 ] and cardiac troponin I (cTnI), [ 6 ] [ 7 ] both of which are also markers for injury to the muscular layer of the heart.
Strenuous endurance exercise such as marathons or triathlons can lead to increased troponin levels in up to one-third of subjects, but it is not linked to adverse health effects in these competitors. [27] [28] [29] High troponin T levels have also been reported in patients with inflammatory muscle diseases such as polymyositis or dermatomyositis.
The onset of symptoms can occasionally be gradual rather than sudden. [8] The cause of pericarditis often remains unknown but is believed to be most often due to a viral infection. [4] [8] Other causes include bacterial infections such as tuberculosis, uremic pericarditis, heart attack, cancer, autoimmune disorders, and chest trauma.
It can be difficult to distinguish unstable angina from non-ST elevation (non-Q wave) myocardial infarction. [4] [5] They differ primarily in whether the ischemia is severe enough to cause sufficient damage to the heart's muscular cells to release detectable quantities of a marker of injury, typically troponin T or troponin I.
Blood pressure may be elevated or decreased, and the pulse can become irregular. [8] [9]: 1444 If heart failure ensues, elevated jugular venous pressure and hepatojugular reflux, or swelling of the legs due to peripheral edema may be found on inspection.
Troponin I is a biomarker that responds to treatment interventions. Reductions in troponin I levels proved to reduce the risk of future CVD. [23] [24] [25] High sensitive troponin I used as a screening tool to assess a person's cardiovascular risk and has the potential to reduce the growing cost burden of the healthcare system. [26]