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MYOCARDITIS
PRESENTED BY
MARIYA JOSHY
4TH YEAR BSC NURSING
HOLY CROSS COLLEGE OF
NURSING, ADOOR
INTRODUCTION
 MYOCARDIUM IS THE INFLAMMATION OF THE MYOCARDIUM
THAT CAUSES AN INFILTRATE IN THE MYOCARDIAL
INTERSTITIUM AND INJURY TO AN ADJACENT MYOCARDIAL
CELLS .IT MAY BE PRIMARY OR SECONDARY.
DEFINITION
 MYOCARDITIS IS AN INFLAMMATORY PROCESS
INVOLVING THE MYOCARDIUM.
MYOCARDITIS
CAUSES
 VIRAL
 BACTERIAL
 FUNGAL
 PARASITIC
 TOXINS
 HYPERSENSITIVITY
 AUTOIMMUNE ACTIVATION
PATHOPHYSIOLOGY
ETIOLOGICAL FACTORS
⬇️
INVASION OF MICROORGANISMS
⬇️
INFLAMMATORY REACTIONS
⬇️
CELLULAR DAMAGE AND NECROSIS
⬇️
INFECTION PROGRESSES
⬇️
AUTOIMMUNE RESPONSE ACTIVATED
⬇️
LEADS TO FURTHER DESTRUCTION OF MYOCYTES
⬇️
CARDIAC DYSFUNCTION
⬇️
DEVELOPS DILATED CARDIOMYOPATHY
CLINICAL
MANIFESTATIONS
• FEVER
• FATIGUE
• MALAISE
• MYALGIA
• PHARYNGITIS
• DYSPNOEA
• LYMPHADENOPATHY
• NAUSEA
DIAGNOSTIC STUDIES
• HISTORY COLLECTION
• PHYSICAL EXAMINATION
• LABORATORY FINDINGS
• HISTOLOGIC FINDINGS : BIOPSY
• ELECTROCARDIOGRAPHY
• ECHOCARDIOGRAPHY
• NUCLEAR SCANS
• MAGNETIC RESONANCE IMAGING
EXPANDED CRITERIA FOR
DIAGNOSIS
 CATEGORY 1
 CATEGORY 2
 CATEGORY 3
 CATEGORY 4
 CATEGORY 1
1. FEVER
2. CHEST PAIN
3. PALPITATIONS
4. FATIGUE
5. SYNCOPE
 CATEGORY 2
1. CARDIAC DILATATION
2. REGIONAL CARDIAC
HYPERTROPHY
3. TROPONIN RELEASE
HIGH SENSITIVITY
 CATEGORY 3
1. INCREASED
MYOCARDIAL T2
SIGNAL
2. DELAYED CONTRAST
ENHANCEMENT
 CATEGORY 4
1. PATHOLOGY FINDINGS
2. PRESENCE OF VIRAL
GENOME
MANAGEMENT
GENERAL MANAGEMENT
 OXYGEN THERAPY
 RESTRICTED ACTIVITIES
 BEDREST
MEDICAL MANAGEMENT
 LANOXIN AND DIGOXIN
 DIURETICS
 VASODILATORS
 ANTIVIRAL AGENTS
NURSING MANAGEMENT
• REDUCING FEVER
• REDUCING FATIGUE
• MAINTAINING CARDIAC OUTPUT
• ADMINISTERING MEDICATIONS
NURSING DIAGNOSIS
• DECREASED CARDIAC OUTPUT RELATED TO RESTRICTED
CARDIAC MUSCLE CONTRACTILITY.
• IMPAIRED GAS EXCHANGE RELATED TO AIRFLOW OBSTRUCTION
AS EVIDENCED BY DECREASED OXYGEN SATURATION LEVEL.
• IMPAIRED TISSUE PERFUSION RELATED TO DECREASED
CARDIAC CONTRACTILITY AND EXPIRATORY AIRFLOW
OBSTRUCTION AS EVIDENCED BY INCREASED CAPILLARY
REFILL TIME >3 SECONDS.
• ACTIVITY INTOLERANCE RELATED TO DECREASED CARDIAC
• FATIGUE RELATED TO DECREASED CARDIAC ACTIVITY AS
EVIDENCED BY DIFFICULTY IN PERFORMING ADL.
SUMMARY
MYOCARDITIS IS AN INFLAMMATORY PROCESS INVOLVING THE
MYOCARDIUM MAINLY CAUSED BY BACTERIA,FUNGI,
PARASITE, CHEMICAL FACTORS.IT MAY BE PRIMARY OR
SECONDARY.ONE OF THE COMMON CAUSE IS THE DILATED
CARDIOMYOPATHY.
CONCLUSION
INFLAMMATION OF THE MYOCARDIUM WHICH CAN CAUSE
HEART DILATATION,THROMBI ON THE HEART WALL,
INFILTRATION OF CIRCULATING BLOOD CELLS AND BETWEEN
THE MUSCLE FIBERS AND DEGENERATION OF THE MUSCLE
FIBERS THEMSELVES.
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