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{{Myocarditis}}
{{Myocarditis}}


{{CMG}} '''Associate Editor-In-Chief:''' [[Varun Kumar]], M.B.B.S., {{CZ}}, {{Maliha}}{{Homa}}
{{CMG}} {{AE}} [[Varun Kumar]], M.B.B.S., {{CZ}}, {{Maliha}}{{Homa}}


==Overview==
==Overview==
In young adults, up to 20% of all cases of [[sudden death]] are due to myocarditis. Myocarditis is slightly more frequent among males than females.
The [[incidence]] of myocarditis is approximately 10 to 20 per 100,000 [[patients]] worldwide. It commonly affects younger individuals. Yong [[males]] are slightly more commonly affected by myocarditis than [[females]]. There is no [[racial]] predilection to myocarditis. [[Viral infections]] especially [[coxsackie B]] and [[enterovirus]] are the most common cause of myocarditis in [[Developed country|developed countries]]. While, In South America, [[Chagas' disease]] (caused by ''[[Trypanosoma cruzi]]'') is the main cause of myocarditis.  
==Epidemiology and Demographics==
==Epidemiology and Demographics==
===Incidence===
*The [[incidence]] of myocarditis is approximately 10 to 20 per 100,000 [[patients]] worldwide. <ref>{{Cite journal
| author = [[Michael Kang]] & [[Jason An]]
| title = Viral Myocarditis
| year = 2019
| month = January
| pmid = 29083732
}}</ref>
===Prevalence===
===Prevalence===
In routine [[autopsy|autopsies]], 1-9% of all patients had evidence of myocardial inflammation.
 
*The [[prevalence]] of myocarditis is estimated to be 1.5 million cases annually.


===Age===
===Age===
In young adults, up to 20% of all cases of [[sudden death]] are due to myocarditis.
 
*Myocarditis commonly affects younger individuals; the [[median]] age at [[diagnosis]] of lymphocytic myocarditis is 42 years, and this [[number]] is 43 years in [[giant cell myocarditis]].<ref name="MaronLevine2015">{{cite journal|last1=Maron|first1=Barry J.|last2=Levine|first2=Benjamin D.|last3=Washington|first3=Reginald L.|last4=Baggish|first4=Aaron L.|last5=Kovacs|first5=Richard J.|last6=Maron|first6=Martin S.|title=Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 2: Preparticipation Screening for Cardiovascular Disease in Competitive Athletes|journal=Circulation|volume=132|issue=22|year=2015|issn=0009-7322|doi=10.1161/CIR.0000000000000238}}</ref><ref name="CooperBerry1997">{{cite journal|last1=Cooper|first1=Leslie T.|last2=Berry|first2=Gerald J.|last3=Shabetai|first3=Ralph|title=Idiopathic Giant-Cell Myocarditis — Natural History and Treatment|journal=New England Journal of Medicine|volume=336|issue=26|year=1997|pages=1860–1866|issn=0028-4793|doi=10.1056/NEJM199706263362603}}</ref>
*Among competitive [[athletes]], myocarditis is accused of the third [[Causes|cause]] of [[Sudden cardiac death|sudden cardiac death.]]
 
===Gender===
===Gender===
Myocarditis is slightly more frequent among males than females. This may be due to protection conferred by the ovarian cycle.<ref name="pmid15527830">{{cite journal| author=Schwartz J, Sartini D, Huber S| title=Myocarditis susceptibility in female mice depends upon ovarian cycle phase at infection. | journal=Virology | year= 2004 | volume= 330 | issue= 1 | pages= 16-23 | pmid=15527830 | doi=10.1016/j.virol.2004.06.051 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15527830  }} </ref>
 
* Yong [[males]] are slightly more commonly affected by myocarditis than [[females]]. This may be due to protection conferred by the [[Ovarian|ovarian cycle]].<ref name="pmid15527830">{{cite journal| author=Schwartz J, Sartini D, Huber S| title=Myocarditis susceptibility in female mice depends upon ovarian cycle phase at infection. | journal=Virology | year= 2004 | volume= 330 | issue= 1 | pages= 16-23 | pmid=15527830 | doi=10.1016/j.virol.2004.06.051 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15527830  }} </ref>


===Race===
===Race===
No difference in frequency of myocarditis has been observed between various races.
 
* There is no [[racial]] predilection to myocarditis.


===Etiology in Developed Countries===
===Etiology in Developed Countries===
*Viral infections are the most common cause of myocarditis in developed countries.
*[[Viral infections]] are the most common cause of myocarditis in [[Developed country|developed countries]]. <ref name="pmid8682098">{{cite journal| author=Friman G, Wesslén L, Fohlman J, Karjalainen J, Rolf C| title=The epidemiology of infectious myocarditis, lymphocytic myocarditis and dilated cardiomyopathy. | journal=Eur Heart J | year= 1995 | volume= 16 Suppl O | issue=  | pages= 36-41 | pmid=8682098 | doi= | pmc= | url= }} </ref><ref name="pmid18645053">{{cite journal| author=Kindermann I, Kindermann M, Kandolf R, Klingel K, Bültmann B, Müller T et al.| title=Predictors of outcome in patients with suspected myocarditis. | journal=Circulation | year= 2008 | volume= 118 | issue= 6 | pages= 639-48 | pmid=18645053 | doi=10.1161/CIRCULATIONAHA.108.769489 | pmc= | http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18645053  }} </ref><ref name="pmid15699250">{{cite journal| author=Kühl U, Pauschinger M, Noutsias M, Seeberg B, Bock T, Lassner D et al.| title=High prevalence of viral genomes and multiple viral infections in the myocardium of adults with "idiopathic" left ventricular dysfunction. | journal=Circulation | year= 2005 | volume= 111 | issue= 7 | pages= 887-93 | pmid=15699250 | doi=10.1161/01.CIR.0000155616.07901.35 | pmc= | http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15699250  }} </ref><ref name="pmid2644885">{{cite journal| author=McAlister HF, Klementowicz PT, Andrews C, Fisher JD, Feld M, Furman S| title=Lyme carditis: an important cause of reversible heart block. | journal=Ann Intern Med | year= 1989 | volume= 110 | issue= 5 | pages= 339-45 | pmid=2644885 | doi= | pmc= | url= }} </ref>
*Common viral causes include [[coxsackie B]] and [[enterovirus]]. 
*Common [[viral]] causes include [[coxsackie B]] and [[enterovirus]].
*The frequency of [[dilated cardiomyopathy]] secondary to [[myocarditis]] is 7.5-10 per 100,000 individuals with enterovirus infections, with the Coxsackie-B viruses being the most common cause.<ref name="pmid8682098">{{cite journal| author=Friman G, Wesslén L, Fohlman J, Karjalainen J, Rolf C| title=The epidemiology of infectious myocarditis, lymphocytic myocarditis and dilated cardiomyopathy. | journal=Eur Heart J | year= 1995 | volume= 16 Suppl O | issue=  | pages= 36-41 | pmid=8682098 | doi= | pmc= | url= }} </ref>  
*The [[frequency]] of [[dilated cardiomyopathy]] [[secondary]] to [[myocarditis]] is 7.5-10 per 100,000 individuals with [[enterovirus]] [[infections]], with the [[Coxsackie B virus|Coxsackie-B viruses]] being the most common cause.
*Recent studies show that [[adenovirus]], [[parvovirus B19]], [[hepatitis C]], and [[human herpes virus 6]] were the common causes for myocarditis.<ref name="pmid18645053">{{cite journal| author=Kindermann I, Kindermann M, Kandolf R, Klingel K, Bültmann B, Müller T et al.| title=Predictors of outcome in patients with suspected myocarditis. | journal=Circulation | year= 2008 | volume= 118 | issue= 6 | pages= 639-48 | pmid=18645053 | doi=10.1161/CIRCULATIONAHA.108.769489 | pmc= | http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18645053  }} </ref><ref name="pmid15699250">{{cite journal| author=Kühl U, Pauschinger M, Noutsias M, Seeberg B, Bock T, Lassner D et al.| title=High prevalence of viral genomes and multiple viral infections in the myocardium of adults with "idiopathic" left ventricular dysfunction. | journal=Circulation | year= 2005 | volume= 111 | issue= 7 | pages= 887-93 | pmid=15699250 | doi=10.1161/01.CIR.0000155616.07901.35 | pmc= | http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15699250  }} </ref>
*Recent studies show that [[adenovirus]], [[parvovirus B19]], [[hepatitis C]], and [[human herpes virus 6]] were the common causes for myocarditis.
*Myocarditis secondary to [[lyme disease]] should be suspected in people traveling to regions where it is endemic, particularly if there are associated conduction abnormalities of the heart.<ref name="pmid2644885">{{cite journal| author=McAlister HF, Klementowicz PT, Andrews C, Fisher JD, Feld M, Furman S| title=Lyme carditis: an important cause of reversible heart block. | journal=Ann Intern Med | year= 1989 | volume= 110 | issue= 5 | pages= 339-45 | pmid=2644885 | doi= | pmc= | url= }} </ref>
*Myocarditis [[secondary]] to [[lyme disease]] should be suspected in people traveling to regions where it is [[endemic]], particularly if there are associated [[Conduction disorders|conduction abnormalities]] of the [[heart]].


===Etiology in Developing Countries===
===Etiology in Developing Countries===
In South America, [[Chagas' disease]] (caused by ''[[Trypanosoma cruzi]]'') is the main cause of myocarditis. Other causes in developing countries include [[rheumatic fever]]<ref name="pmid16253886">{{cite journal| author=Carapetis JR, Steer AC, Mulholland EK, Weber M| title=The global burden of group A streptococcal diseases. | journal=Lancet Infect Dis | year= 2005 | volume= 5 | issue= 11 | pages= 685-94 | pmid=16253886 | doi=10.1016/S1473-3099(05)70267-X | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16253886  }} </ref> and [[HIV infection]].
In South America, [[Chagas' disease]] (caused by ''[[Trypanosoma cruzi]]'') is the main cause of myocarditis. Other causes in developing countries include [[rheumatic fever]] and [[HIV infection]].<ref name="pmid16253886">{{cite journal| author=Carapetis JR, Steer AC, Mulholland EK, Weber M| title=The global burden of group A streptococcal diseases. | journal=Lancet Infect Dis | year= 2005 | volume= 5 | issue= 11 | pages= 685-94 | pmid=16253886 | doi=10.1016/S1473-3099(05)70267-X | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16253886  }} </ref>
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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Latest revision as of 22:51, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S., Cafer Zorkun, M.D., Ph.D. [2], Maliha Shakil, M.D. [3] Homa Najafi, M.D.[4]

Overview

The incidence of myocarditis is approximately 10 to 20 per 100,000 patients worldwide. It commonly affects younger individuals. Yong males are slightly more commonly affected by myocarditis than females. There is no racial predilection to myocarditis. Viral infections especially coxsackie B and enterovirus are the most common cause of myocarditis in developed countries. While, In South America, Chagas' disease (caused by Trypanosoma cruzi) is the main cause of myocarditis.

Epidemiology and Demographics

Incidence

Prevalence

  • The prevalence of myocarditis is estimated to be 1.5 million cases annually.

Age

Gender

  • Yong males are slightly more commonly affected by myocarditis than females. This may be due to protection conferred by the ovarian cycle.[4]

Race

  • There is no racial predilection to myocarditis.

Etiology in Developed Countries

Etiology in Developing Countries

In South America, Chagas' disease (caused by Trypanosoma cruzi) is the main cause of myocarditis. Other causes in developing countries include rheumatic fever and HIV infection.[9]

References

  1. Michael Kang & Jason An (2019). "Viral Myocarditis". PMID 29083732. Unknown parameter |month= ignored (help)
  2. Maron, Barry J.; Levine, Benjamin D.; Washington, Reginald L.; Baggish, Aaron L.; Kovacs, Richard J.; Maron, Martin S. (2015). "Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 2: Preparticipation Screening for Cardiovascular Disease in Competitive Athletes". Circulation. 132 (22). doi:10.1161/CIR.0000000000000238. ISSN 0009-7322.
  3. Cooper, Leslie T.; Berry, Gerald J.; Shabetai, Ralph (1997). "Idiopathic Giant-Cell Myocarditis — Natural History and Treatment". New England Journal of Medicine. 336 (26): 1860–1866. doi:10.1056/NEJM199706263362603. ISSN 0028-4793.
  4. Schwartz J, Sartini D, Huber S (2004). "Myocarditis susceptibility in female mice depends upon ovarian cycle phase at infection". Virology. 330 (1): 16–23. doi:10.1016/j.virol.2004.06.051. PMID 15527830.
  5. Friman G, Wesslén L, Fohlman J, Karjalainen J, Rolf C (1995). "The epidemiology of infectious myocarditis, lymphocytic myocarditis and dilated cardiomyopathy". Eur Heart J. 16 Suppl O: 36–41. PMID 8682098.
  6. Kindermann I, Kindermann M, Kandolf R, Klingel K, Bültmann B, Müller T; et al. (2008). "Predictors of outcome in patients with suspected myocarditis". Circulation. 118 (6): 639–48. doi:10.1161/CIRCULATIONAHA.108.769489. PMID 18645053. Unknown parameter |http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom= ignored (help)
  7. Kühl U, Pauschinger M, Noutsias M, Seeberg B, Bock T, Lassner D; et al. (2005). "High prevalence of viral genomes and multiple viral infections in the myocardium of adults with "idiopathic" left ventricular dysfunction". Circulation. 111 (7): 887–93. doi:10.1161/01.CIR.0000155616.07901.35. PMID 15699250. Unknown parameter |http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom= ignored (help)
  8. McAlister HF, Klementowicz PT, Andrews C, Fisher JD, Feld M, Furman S (1989). "Lyme carditis: an important cause of reversible heart block". Ann Intern Med. 110 (5): 339–45. PMID 2644885.
  9. Carapetis JR, Steer AC, Mulholland EK, Weber M (2005). "The global burden of group A streptococcal diseases". Lancet Infect Dis. 5 (11): 685–94. doi:10.1016/S1473-3099(05)70267-X. PMID 16253886.

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