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Myocarditis and Pericarditis 

Myocarditis and Pericarditis
Chapter:
Myocarditis and Pericarditis
Author(s):

Kevin Alexander

DOI:
10.1093/med/9780199976805.003.0019
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date: 24 October 2021

Infectious myocarditis is a primary, inflammatory cardiomyopathy that can lead to cardiomyocyte toxicity via direct myocyte invasion, toxin production, and/or stimulation of a chronic inflammatory response through antigenic mimicry. Its incidence is difficult to determine due to significant disease heterogeneity and the lack of a noninvasive gold standard for diagnosis. Often, the causative pathogen is not identified; in cases where it is, appropriate anti-infective agents may be used. Treatment is primarily supportive. Acute infectious pericarditis involves inflammation of the parietal and visceral layers of the pericardial sac that surround the heart. Because infectious pericarditis usually has a viral etiology, antibiotics are only started if blood or pericardial effusion cultures demonstrate a bacterial or fungal cause. Purulent pericarditis and cardiac tamponade should be treated with drainage via either pericardiocentesis or a pericardiotomy. Pericardial resection is the only treatment for constrictive pericarditis.

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