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[pearl provided by Dr. Semhar Tewelde]
Myocarditis is an under-diagnosed cardiac disease resulting from a broad range of infectious, immune, and toxic etiologies
Symptoms range from asymptomatic, dyspnea (most commonly) and chest pain, to presentations with signs of myocardial infarction, pericardial effusion with cardiac tamponade, to devastating illness with cardiogenic shock
Etiologies to consider
Bacteria (tuberculosis, strep pneumonia, chlamydia, legionella, mycoplasma)
Fungi (candida, aspergillosis, actinomyces, crypotococcus)
Helminthic (trichinella, echinococcus)
Protozoal (toxoplasma, trypanosoma)
Viral (adeno, echo, parvo, entero e.g., coxsackie, HSV, CMV, EBV, HIV)
Rickettsial (coxiellia, rickettsia)
Spirochetes (borrelia, treponema, leptospirosis)
Autoimmune diseases (celiac, churg-strauss, crohn's/UC, dermatomyositis, giant cell,
lupus, RA, sarcoidosis, kawasaki)
Toxic reactions to drug (amphetamines, anthracyclines, catecholamines, cocaine, phenytoin)
Others (ethanol, copper, iron, radiotherapy, thyroid storm)
References
Kindermann I, Barth C, Mahfoud F, et al. Update on Myocarditis. JACC:59;9 Feb 28, 2012.