Myocarditis may be accompanied by pericarditis
Fever, myalgias, headache, and sinus tachycardia, often out of proportion with fever
Retrosternal or precordial angina-type chest pain
may occur and is usually due to pericardial inflammation (myopericarditis)
Gold standard for diagnosis : endocardial biopsy
CXR : usually normal or nondiagnostic
Cardiomegaly and pulmonary venous hypertension or pulmonary edema in severe disease.
ECG : nonspecific ST-T–wave changes,
ST-segment elevation or PR depression from associated pericarditis, atrioventricular block, and QRS interval prolongation.
Troponin or B-type natriuretic peptide may be elevated.
Echocardiography : nonspecific, with myocardial depression and wall motion abnormalities in severe cases
Immunosuppressive therapy (e.g., prednisone, azathioprine, and others)
may be of value in selected patients, but large trials have not consistently demonstrated benefit.
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