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Emergency: requires immediate attention
Myopericarditis
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Emergency: requires immediate attention

Myopericarditis

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Contributors: Michael W. Winter MD, Benjamin L. Mazer MD, MBA, Ryan Hoefen MD, PhD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Myopericarditis is a condition characterized by inflammation of the pericardium (pericarditis) with concurrent involvement of the adjacent myocardial layer. Myopericarditis usually presents similarly to pericarditis with chest pain, fever, and shortness of breath. Myocardial involvement is identified either by serologic testing (ie, elevated troponin) or by imaging demonstrating myocardial inflammation (ie, cardiac MRI) in the absence of underlying cardiac dysfunction.

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

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Last Reviewed: 02/04/2019
Last Updated: 07/19/2019
Copyright © 2019 VisualDx®. All rights reserved.
Emergency: requires immediate attention
Myopericarditis
Print 1 Images
Myopericarditis : Chest pain, Fever, Pericardial effusion, Pericardial friction rub, Dyspnea
Copyright © 2019 VisualDx®. All rights reserved.