Emergency: requires immediate attention
Myopericarditis
Alerts and Notices
Synopsis
Myopericarditis is presumed to be caused most commonly by viral infections. Frequently implicated organisms include coxsackieviruses, adenoviruses, herpes viruses, echoviruses, influenza, hepatitis C, and parvovirus B19. Bacterial, fungal, rickettsial, helminthic, protozoal, and mycotic organisms have been associated with myopericarditis but much less commonly so. Over 50% of cases of tuberculous pericarditis are actually myopericarditis. Numerous other underlying conditions have also been associated with myopericarditis. These include many autoimmune diseases, adverse reactions to medications, vasculitis, autoinflammatory diseases, and trauma.
Although many cases of myopericarditis have only minimal cardiac symptoms with systemic symptoms of infection or inflammation such as fevers, muscle aches, and gastrointestinal symptoms predominating, those who are symptomatic will have symptoms of pericarditis (positional or pleuritic chest pain, often alleviated by leaning forward), myocarditis (exertional chest pains and possibly signs of heart failure), or a mix of both.
A friction rub is the characteristic finding on auscultation of the heart. When infectious etiologies are suspected, patients may have sequelae of their specific viral syndrome or a recent history of an illness.
Unlike isolated myocarditis, myopericarditis does not typically lead to poor long-term cardiovascular outcomes, such as congestive heart failure, as most patients are expected to have a full recovery. Nonsteroid anti-inflammatory drugs (NSAIDs) are often effective therapy.
Codes
ICD10CM:I30.9 – Acute pericarditis, unspecified
SNOMEDCT:
11176009 – Acute myopericarditis
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
- Acute coronary syndrome
- Cardiomyopathy (see, eg, dilated cardiomyopathy, restrictive cardiomyopathy)
- Myocarditis
- Endocarditis
- Pleurisy
- Costochondritis
- Pulmonary embolism
- Aortic dissection
- Gastroesophageal reflux disease
- Pneumonia
- Esophageal spasm
- Achalasia
- Esophagitis
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
References
Subscription Required
Last Reviewed:02/03/2019
Last Updated:05/18/2020
Last Updated:05/18/2020
Emergency: requires immediate attention
Myopericarditis