Materiały źródłowe

• #1 Myocarditis: Symptoms and Causes

  https://my.clevelandclinic.org/health/diseases/22129-myocarditis

  Myocarditis is inflammation of the heart muscle, or myocardium. This inflammation weakens your heart muscle, making it harder for your heart to pump. This can be caused by viral infections or inflammatory conditions. […] Myocarditis is inflammation of your heart muscle (myocardium). This can weaken your heart muscle, making it more difficult for your heart to pump. This rare condition can affect people quickly or slowly over time. […] People with myocarditis often feel fatigued, short of breath, chest pain or the sensation of their heart racing (palpitations). […] If you have a mild case, it may go away on its own. If not, your provider can order medicines for you. […] To treat myocarditis, your healthcare provider may want you to take medication. These include: Medicines for heart failure, Corticosteroids, Intravenous (IV) immunoglobulin.

• #2 Myocarditis Causes, Symptoms, and Treatments

  https://www.upmc.com/services/heart-vascular/conditions/myocarditis

  Myocarditis is a rare disease that causes the heart muscle to become inflamed. […] It weakens the heart muscle and makes it harder for the heart to pump. […] Myocarditis is an inflammation of the heart muscle (the myocardium), often caused by a virus or autoimmune disease. […] It can weaken the heart, making it harder to pump blood. […] Myocarditis is a rare disease and can be mild or severe. […] In the worst cases, it can lead to: Heart failure. Abnormal heart rhythms. Shock. Sudden death. […] Myocarditis can affect all age groups, including children but occurs more often in young adults. […] Myocarditis caused by autoimmune disease is more common in women, and the other types are more common in men. […] Your doctor may prescribe one or more of these medications to help treat your myocarditis: Corticosteroids. These drugs can calm the body’s immune system if an autoimmune disease triggered myocarditis.

• #3

  https://journals.lww.com/nursing/fulltext/2004/10000/muscle_up_your_knowledge_of_myocarditis.12.aspx

  AN INFLAMMATION of the myocardium, myocarditis is typically triggered by an enterovirus such as coxsackievirus, although many other possible causes have been identified. […] Although myocarditis is usually mild and self-limiting, it can lead to arrhythmias, pericarditis, chronic dilated cardiomyopathy, and heart failure. […] Treatment for myocarditis depends on the underlying cause. Supportive care includes bed rest and avoiding strenuous exercise until the ECG returns to normal. […] Keep the patient on bed rest to decrease the heart’s workload. […] Closely monitor him for arrhythmias and treat them as ordered. […] Regularly perform physical assessments to identify signs and symptoms of heart failure. […] Before discharge, explain any activity limitations or diet restrictions and teach him how to recognize the signs and symptoms of heart failure. […] Tell him to contact his cardiologist or dial 911 immediately if symptoms worsen.

• #4 COVID-19 vaccination is safe in patients with previous myocarditis

  https://www.escardio.org/The-ESC/Press-Office/Press-releases/COVID-19-vaccination-is-safe-in-patients-with-previous-myocarditis

  Myocarditis is an inflammation of the heart muscle. Signs and symptoms include fatigue, chest pain, shortness of breath, and rapid heartbeats. The inflammation can reduce the heart’s ability to pump and can also cause arrhythmias (irregular heartbeats). Prevalence is estimated at 10 to 106 cases per 100,000 individuals worldwide. The leading cause of myocarditis is viral infection. […] Dr. Abou Saleh said: We showed that SARS-CoV-2 vaccination in patients with a history of acute myocarditis is not associated with a risk of recurrent myocarditis or other serious side effects. Our results should be interpreted with caution due to the small number of patients and the predominant use of one type of vaccine.

• #5 Myocarditis in children – Children’s Health Cardiology

  https://www.childrens.com/specialties-services/conditions/myocarditis

  Myocarditis usually is caused by a viral infection, including flu viruses, cold viruses, parvoviruses (called fifth disease) and COVID-19. These viral infections cause an immune response that leads to inflammation in the heart. This may be the same reason that mild myocarditis can be a very rare side effect of some COVID-19 vaccines. […] Mild myocarditis can get better on its own or with medication. Children may need to rest and avoid sports for three to six months while they recover from the infection that caused the inflammation. Its important to diagnose and treat myocarditis early. Children with mild myocarditis typically recover completely. […] For more severe myocarditis, the heart can take a while to heal. We may use heart medicines like beta blockers or ACE inhibitors. Doctors may also use IVIG (intravenous immune globulin) or steroids. Some children may need to spend time in the ICU and may need help from a mechanical ventilator to temporarily support their heart and lungs. […] In the most severe cases, a child may need a heart transplant. The pediatric cardiology care team at Childrens Health can provide complete care, from early diagnosis to the most advanced treatments.

• #6 Myocarditis: Symptoms and Causes

  https://my.clevelandclinic.org/health/diseases/22129-myocarditis

  Myocarditis is inflammation of the heart muscle, or myocardium. This inflammation weakens your heart muscle, making it harder for your heart to pump. This can be caused by viral infections or inflammatory conditions. […] Myocarditis is inflammation of your heart muscle (myocardium). This can weaken your heart muscle, making it more difficult for your heart to pump. This rare condition can affect people quickly or slowly over time. […] People with myocarditis often feel fatigued, short of breath, chest pain or the sensation of their heart racing (palpitations). […] If you have a mild case, it may go away on its own. If not, your provider can order medicines for you. […] To treat myocarditis, your healthcare provider may want you to take medication. These include: Medicines for heart failure, Corticosteroids, Intravenous (IV) immunoglobulin.

• #7 Understanding Myocarditis 

  https://www.veteranshealthlibrary.va.gov/RelatedItems/142,41700_VA

  Myocarditis is inflammation of the heart muscle. It can affect people of any age or demographic. This condition is typically diagnosed during the evaluation of symptoms like fatigue, shortness of breath, palpitations, or fainting, but can also occur without symptoms. This inflammation can be triggered by any stress on the heart, but is typically associated with an infection, a drug or toxin, or an autoimmune condition. Most cases of myocarditis are mild and resolve with removal of the cause for inflammation. However, in rare cases, an uncontrolled inflammatory response can lead to severe symptoms, life-threatening heart rhythms, heart pump failure, and even death. Treatment for myocarditis targets the underlying cause of inflammation, and may also include medicines, devices, or surgeries for abnormal rhythms and heart failure.

• #8 Nursing Considerations for ICI-Related Myocarditis | Oncology Nursing Society

  https://www.ons.org/news-and-views/nursing-considerations-for-ici-related-myocarditis

  Before immunotherapies like immune checkpoint inhibitors (ICIs) became a cancer treatment option, myocarditis typically developed in the presence of infections, drug allergies, or autoimmune diseases. […] In their article in the February 2022 issue of the Clinical Journal of Oncology Nursing, Kuhnly and Coviello analyzed and consolidated the evidence for oncology nurses to recognize, monitor, and manage patients with cancer who are experiencing ICI-related myocarditis. […] ICI-related myocarditis occurs in about 0.4%1.14% of patients, Kuhnly and Coviello reported, but mortality rates range from 25%50% despite treatment intervention. […] Patients may be asymptomatic or experience severe symptoms according to the Common Terminology Criteria for Adverse Events scale: […] Significant arrhythmias occur in 19% of patients with ICI-related myocarditis, most commonly complete heart block.

• #9 Myocarditis in children – Children’s Health Cardiology

  https://www.childrens.com/specialties-services/conditions/myocarditis

  Myocarditis usually is caused by a viral infection, including flu viruses, cold viruses, parvoviruses (called fifth disease) and COVID-19. These viral infections cause an immune response that leads to inflammation in the heart. This may be the same reason that mild myocarditis can be a very rare side effect of some COVID-19 vaccines. […] Mild myocarditis can get better on its own or with medication. Children may need to rest and avoid sports for three to six months while they recover from the infection that caused the inflammation. Its important to diagnose and treat myocarditis early. Children with mild myocarditis typically recover completely. […] For more severe myocarditis, the heart can take a while to heal. We may use heart medicines like beta blockers or ACE inhibitors. Doctors may also use IVIG (intravenous immune globulin) or steroids. Some children may need to spend time in the ICU and may need help from a mechanical ventilator to temporarily support their heart and lungs. […] In the most severe cases, a child may need a heart transplant. The pediatric cardiology care team at Childrens Health can provide complete care, from early diagnosis to the most advanced treatments.

• #10 What to tell patients about myocarditis after COVID-19 vaccination | AMA

  https://www.ama-assn.org/delivering-care/public-health/what-tell-patients-about-myocarditis-after-covid-19-vaccination

  Confirmed cases have occurred mostly in male adolescents and young adults aged 16 years or older. […] The CDCs Advisory Committee on Immunization Practices, or ACIP, met to discuss this issue last week, AMA Chief Health and Science Officer Mira Irons, MD, said during an episode of AMA COVID-19 Update on vaccination challenges and masking guidance. […] Importantly, for the young people who do, most cases are mild, and individuals recover often on their own or with minimal treatment. […] If a parent or their child has any of these symptoms within a week after COVID-19 vaccination, it is important to seek medical care. For instances of myocarditis and pericarditis after mRNA COVID-19 vaccination, most who received medical care have responded well to medications and rest. […] The benefits of COVID-19 vaccination far outweigh the risks of heart inflammation in young people, said Dr. Irons, adding that it’s important to remember that the risk for COVID is far higher.

• #11 Myocarditis

  https://www.myamericannurse.com/myocarditis/

  Early recognition may help save a life. […] Nurses should have a high suspicion for serious illness such as myocarditis in pediatric patients who present with respiratory distress that fails to respond to standard treatment. […] Myocarditis has high rates of morbidity and mortality in children, so nurses should be aware of its causes and symptoms. […] Although rare, myocarditis can lead to heart failure and death if it’s not rapidly diagnosed and treated. In milder cases such as Samantha’s, care is supportive and consists of antiarrhythmics, diuretics, and supplemental oxygen to treat symptoms of acute heart failure. Severe cases may result in dilated cardiomyopathy, heart transplant, and death. […] Rapid recognition of a patient’s failure to respond to standard treatment is important to providing the best possible outcome. In Samantha’s case, it may have saved her life.

• #12 Myocarditis: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/myocarditis/?srsltid=AfmBOoreyuCfyEGsmlzR3tpBD16JlQPC9P-cdOZI9aijEc3bgK9vGL05

  Assess for signs and symptoms of myocarditis, such as: Shortness of breath, Chest pain, Fatigue, Fever, Heart arrhythmias, Anxiety. […] Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnoses, interventions, expected outcomes, and education for myocarditis are listed below. […] Monitor pain level. […] Monitor vital signs. […] Provide non-pharmacological interventions for pain. […] Provide a quiet environment. […] Monitor ability to perform activities of daily living. […] Assist with activities of daily living as needed. […] Observe for verbal and non-verbal signs of anxiety. […] Identify ways to decrease anxiety, such as relaxation techniques. […] Encourage participation in activities. […] Verbalizes a decrease in pain.

• #13 Myocarditis: Causes, Symptoms, Treatment & Tests You May Need

  https://www.webmd.com/heart-disease/myocarditis

  Myocarditis often has no symptoms. In fact, most people recover and never even know they had it. […] If you do have symptoms, they may include: Shortness of breath, Abnormal heartbeat, which causes fainting in rare cases, Lightheadedness, A sharp or stabbing chest pain or pressure, which may spread to your neck and shoulders, Fatigue, Signs of infection, such as Fever, Muscle aches, Sore throat, Headache, Diarrhea, Painful joints, Swollen joints, legs, feet, or neck veins, Small amounts of urine, Loss of appetite, Weakness. […] Call your doctor right away if you have symptoms of myocarditis. If you have or had an infection, its more likely that you have the condition. Seek immediate medical care if your symptoms are severe. If your symptoms such as chest pain, trouble breathing, or swelling have gotten worse since you were told you have myocarditis, call 911 or go to the hospital.

• #14 Myocarditis: Causes, Symptoms, Treatment & Tests You May Need

  https://www.webmd.com/heart-disease/myocarditis

  Myocarditis often has no symptoms. In fact, most people recover and never even know they had it. […] If you do have symptoms, they may include: Shortness of breath, Abnormal heartbeat, which causes fainting in rare cases, Lightheadedness, A sharp or stabbing chest pain or pressure, which may spread to your neck and shoulders, Fatigue, Signs of infection, such as Fever, Muscle aches, Sore throat, Headache, Diarrhea, Painful joints, Swollen joints, legs, feet, or neck veins, Small amounts of urine, Loss of appetite, Weakness. […] Call your doctor right away if you have symptoms of myocarditis. If you have or had an infection, its more likely that you have the condition. Seek immediate medical care if your symptoms are severe. If your symptoms such as chest pain, trouble breathing, or swelling have gotten worse since you were told you have myocarditis, call 911 or go to the hospital.

• #15 Nursing Care and Pathophysiology of Myocarditis | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-and-pathophysiology-of-myocarditis

  Myocarditis occurs when the heart muscle (myocardium) becomes inflamed due to an immune system response. […] Myocarditis can be difficult to diagnose due to nonspecific symptoms and signs, but the following tests may be performed: Laboratory testing, ECG, Chest Radiograph. […] While there’s no curative treatment for myocarditis, this condition may actually self-resolve with time; we can help that along for the patient by giving them some pain medication that may help alleviate some of that symptomology they’re experiencing regarding chest pain. […] There are certain things you want to avoid in a patient who’s been diagnosed with myocarditis. One of the very first things is NSAID use. NSAID use is going to make any symptoms that are associated with heart failure even worse in a patient who has myocarditis.

• #16 Myocarditis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/244

  Diagnostic investigations include 12-lead ECG, CXR, serum CK, serum CK-MB, serum troponin (I or T), serum B-type natriuretic peptide, two-dimensional echocardiogram, and 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT). […] Emerging tests include MRI-guided EMB. […] Treatment algorithm includes management for haemodynamically stable and unstable patients, as well as those with end-stage heart failure or refractory life-threatening arrhythmias.

• #17

  https://www.healio.com/news/cardiology/20250107/qa-acc-unveils-new-staging-system-decision-pathway-for-myocarditis-diagnosis-care

  The ACC issued an expert consensus statement on the diagnosis and treatment of myocarditis. […] The document features a new myocarditis staging system and decision pathway for physicians. […] The American College of Cardiology recently issued an expert consensus document outlining a novel staging system and decision pathway for the diagnosis, treatment and longitudinal follow-up of patients with myocarditis. […] There are two knowledge gaps this expert consensus decision pathway intends to fill. The first is a proposed five-step care pathway for the evaluation and treatment of patients with myocarditis. […] The second is a novel staging classification for myocarditis. We proposed a four-stage model, from stages A to D. It reflects the fact that myocarditis is not a static condition, but rather one with trajectories over time.

• #18

  https://www.healio.com/news/cardiology/20250107/qa-acc-unveils-new-staging-system-decision-pathway-for-myocarditis-diagnosis-care

  The five-step care pathway starts with step one: Recognition. […] The second step was what we called Triage. […] The third step was what we called Pivotal diagnostic tests. […] The fourth step is Treatment, and we focused on pharmacological treatment. […] The fifth step is Longitudinal follow-up which, as mentioned previously, includes repeat cardiac imaging at 2 to 4 weeks, and again at 6 months. […] Another important aspect in terms of longitudinal follow-up is related to the increasing evidence of a genetic contribution in a minority of patients with myocarditis. […] We provided specific recommendations on when patients should be referred to an advanced HF center.

• #19 Nursing Management of Patient With Fulminant Myocarditis and Electrical Storm Receiving ECMO: A Case Report – AACN

  https://www.aacn.org/education/ce-activities/c2362/nursing-management-of-patient-with-fulminant-myocarditis-and-electrical-storm-receiving-ecmo-a-case-report

  Fulminant myocarditis (FM) has a low incidence but is associated with poor outcomes. […] Nurses are an integral part of the care team. This article describes specific nursing interventions critical to the treatment of patients with FM, including ECMO, intra-aortic balloon pump (IABP) support, and delivery of high-quality patient care, resulting in a positive patient outcome. […] Describe two nursing interventions bedside nurses use to care for a patient with fulminant myocarditis.

• #20 Myocarditis Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/myocarditis-nursing-diagnosis/

  Myocarditis is an inflammation of the heart muscle (myocardium) that can affect heart function. Understanding the nursing diagnosis for myocarditis is crucial for providing effective care to patients with this condition. […] The nursing assessment is crucial for identifying the severity of myocarditis and guiding appropriate interventions. Here are some aspects of the nursing assessment for patients with myocarditis: […] Nursing interventions play a crucial role in managing patients with myocarditis. Here are key interventions to implement: […] Effective nursing care for patients with myocarditis requires a comprehensive approach addressing both physical and psychological aspects of the condition. […] By implementing these nursing diagnoses, interventions, and care plans, nurses can significantly contribute to improved patient outcomes and quality of life.

• #21 Myocarditis | PPT

  https://www.slideshare.net/slideshow/myocarditis-233464476/233464476

  Myocarditis is an inflammatory disease of the myocardium that can be caused by infectious or non-infectious triggers. It is defined as inflammation of the heart muscle and can lead to dilation, thrombi formation, and degeneration of muscle fibers. Treatment involves managing symptoms through medications like ACE inhibitors, beta-blockers, and diuretics. Immunosuppressive therapy may also be used. Prognosis depends on the severity of cardiac dysfunction, with 50% resolving in 2-4 weeks but 25% developing persistent issues and 12-25% deteriorating acutely. […] The nurse assesses the patients temperature, tachycardia and other clinical manifestations to determine whether the disease is subsiding. The cardiovascular assessment focuses on signs and symptoms of heart failure and dysrhythmia. Patient with dysrhythmias should have continuous cardiac monitoring. Elastic compression stockings and passive and active exercises should be used.

• #22 Myocarditis | PPT

  https://www.slideshare.net/slideshow/myocarditis-233464476/233464476

  Myocarditis is an inflammatory disease of the myocardium that can be caused by infectious or non-infectious triggers. It is defined as inflammation of the heart muscle and can lead to dilation, thrombi formation, and degeneration of muscle fibers. Treatment involves managing symptoms through medications like ACE inhibitors, beta-blockers, and diuretics. Immunosuppressive therapy may also be used. Prognosis depends on the severity of cardiac dysfunction, with 50% resolving in 2-4 weeks but 25% developing persistent issues and 12-25% deteriorating acutely. […] The nurse assesses the patients temperature, tachycardia and other clinical manifestations to determine whether the disease is subsiding. The cardiovascular assessment focuses on signs and symptoms of heart failure and dysrhythmia. Patient with dysrhythmias should have continuous cardiac monitoring. Elastic compression stockings and passive and active exercises should be used.

• #23 Myocarditis Treatment & Management: Approach Considerations, Emergency Department Care, Medical Care

  https://emedicine.medscape.com/article/156330-treatment

  Standard treatment of clinically significant disease includes the detection of dysrhythmia with cardiac monitoring, the administration of supplemental oxygen, and the management of fluid status. […] Left ventricular (LV) dysfunction developing from myocarditis should be approached in much the same manner as other causes of CHF, with some exceptions. In general, sympathomimetic drugs should be avoided, because they increase the extent of myocardial necrosis and mortality. Beta blockers should be avoided in the acutely decompensating phase of illness. […] Surgical care for patient with myocarditis is primarily recommended if medical treatment fails and if the patient is symptomatic. […] Fulminant myocarditis carries a low threshold for ventilatory and MCS (eg, intra-aortic balloon pump) because of the rapidly progressive course of decompensation and the potential for reversal.

• #24 Myocarditis: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/myocarditis/?srsltid=AfmBOoreyuCfyEGsmlzR3tpBD16JlQPC9P-cdOZI9aijEc3bgK9vGL05

  Assess for signs and symptoms of myocarditis, such as: Shortness of breath, Chest pain, Fatigue, Fever, Heart arrhythmias, Anxiety. […] Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnoses, interventions, expected outcomes, and education for myocarditis are listed below. […] Monitor pain level. […] Monitor vital signs. […] Provide non-pharmacological interventions for pain. […] Provide a quiet environment. […] Monitor ability to perform activities of daily living. […] Assist with activities of daily living as needed. […] Observe for verbal and non-verbal signs of anxiety. […] Identify ways to decrease anxiety, such as relaxation techniques. […] Encourage participation in activities. […] Verbalizes a decrease in pain.

• #25 Myocarditis: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/myocarditis/?srsltid=AfmBOoreyuCfyEGsmlzR3tpBD16JlQPC9P-cdOZI9aijEc3bgK9vGL05

  Completes activities of daily living without becoming fatigued. […] Demonstrates decreased anxiety. […] Demonstrates effective coping. […] Condition, treatment, and outcomes. […] Review medications and side effects. […] Follow up with healthcare provider or specialist. […] Review importance of reducing the workload on the heart. […] Avoid alcohol and smoking. […] Up-to-date vaccinations. […] Notify healthcare provider or seek medical attention for: Chest pain, Fever, Shortness of breath, Influenza-like symptoms.

• #26

  https://journals.lww.com/nursing/fulltext/2004/10000/muscle_up_your_knowledge_of_myocarditis.12.aspx

  AN INFLAMMATION of the myocardium, myocarditis is typically triggered by an enterovirus such as coxsackievirus, although many other possible causes have been identified. […] Although myocarditis is usually mild and self-limiting, it can lead to arrhythmias, pericarditis, chronic dilated cardiomyopathy, and heart failure. […] Treatment for myocarditis depends on the underlying cause. Supportive care includes bed rest and avoiding strenuous exercise until the ECG returns to normal. […] Keep the patient on bed rest to decrease the heart’s workload. […] Closely monitor him for arrhythmias and treat them as ordered. […] Regularly perform physical assessments to identify signs and symptoms of heart failure. […] Before discharge, explain any activity limitations or diet restrictions and teach him how to recognize the signs and symptoms of heart failure. […] Tell him to contact his cardiologist or dial 911 immediately if symptoms worsen.

• #27 Nursing Management of Patient With Fulminant Myocarditis and Electrical Storm Receiving ECMO: A Case Report – AACN

  https://www.aacn.org/education/ce-activities/c2362/nursing-management-of-patient-with-fulminant-myocarditis-and-electrical-storm-receiving-ecmo-a-case-report

  Fulminant myocarditis (FM) has a low incidence but is associated with poor outcomes. […] Nurses are an integral part of the care team. This article describes specific nursing interventions critical to the treatment of patients with FM, including ECMO, intra-aortic balloon pump (IABP) support, and delivery of high-quality patient care, resulting in a positive patient outcome. […] Describe two nursing interventions bedside nurses use to care for a patient with fulminant myocarditis.

• #28 Nursing Care Plan for Myocarditis | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-myocarditis

  Nursing Care Plan (NCP) for Myocarditis […] Upon completion of this nursing care plan for Myocarditis, nursing students will be able to: […] Provide in-depth nursing care for patients with myocarditis, focusing on understanding the pathophysiology, etiology, clinical manifestations, and management strategies. This plan emphasizes the importance of timely recognition, appropriate treatment, patient education, and support in managing this condition. […] Desired Outcomes for Myocarditis […] Patient understanding of the condition and its management. […] Nursing Diagnosis for Myocarditis […] Knowledge Deficit regarding disease management and lifestyle modifications. […] Nursing Interventions and Rationales for Myocarditis […] Patient Education: Educate about the importance of medication adherence, lifestyle changes, and recognizing worsening symptoms. […] Rationale: To empower the patient in managing their condition and preventing complications. […] Evaluation for Myocarditis […] Evaluate understanding of myocarditis and self-management skills.

• #29 Myocarditis NCP 2 | PDF | Heart | Heart Failure

  https://www.scribd.com/doc/48416221/MYOCARDITIS-NCP-2

  The nursing care plan outlines goals and interventions for a patient diagnosed with acute myocarditis. Short term goals include the patient reporting increased activity tolerance and displaying normal laboratory values within 1 week. Interventions include assessing the patient’s abilities, noting changes, recommending rest, elevating the head of the bed, and monitoring laboratory studies. The long term goal is for the patient to be free from weakness and risk of complications after 1 week.

• #30 Myocarditis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/myocarditis/diagnosis-treatment/drc-20352544

  Our caring team of Mayo Clinic experts can help you with your myocarditis-related health concerns […] Myocarditis treatment focuses on the cause and the symptoms, such as heart failure. […] People with mild myocarditis may only need rest and medicine. If myocarditis is severe, medicines may be given through an IV at a hospital to quickly improve the heart’s ability to pump blood. […] It’s important to have regular health checkups after myocarditis to check for possible complications. […] Rest and reducing the strain on the heart are important parts of myocarditis recovery. […] If you have or had myocarditis, ask your healthcare professional which type and amount of physical activity is safe for you. If you have myocarditis, you should avoid competitive sports for at least 3 to 6 months.

• #31 Myocarditis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/myocarditis/diagnosis-treatment/drc-20352544

  Our caring team of Mayo Clinic experts can help you with your myocarditis-related health concerns […] Myocarditis treatment focuses on the cause and the symptoms, such as heart failure. […] People with mild myocarditis may only need rest and medicine. If myocarditis is severe, medicines may be given through an IV at a hospital to quickly improve the heart’s ability to pump blood. […] It’s important to have regular health checkups after myocarditis to check for possible complications. […] Rest and reducing the strain on the heart are important parts of myocarditis recovery. […] If you have or had myocarditis, ask your healthcare professional which type and amount of physical activity is safe for you. If you have myocarditis, you should avoid competitive sports for at least 3 to 6 months.

• #32

  https://journals.lww.com/nursing/fulltext/2004/10000/muscle_up_your_knowledge_of_myocarditis.12.aspx

  AN INFLAMMATION of the myocardium, myocarditis is typically triggered by an enterovirus such as coxsackievirus, although many other possible causes have been identified. […] Although myocarditis is usually mild and self-limiting, it can lead to arrhythmias, pericarditis, chronic dilated cardiomyopathy, and heart failure. […] Treatment for myocarditis depends on the underlying cause. Supportive care includes bed rest and avoiding strenuous exercise until the ECG returns to normal. […] Keep the patient on bed rest to decrease the heart’s workload. […] Closely monitor him for arrhythmias and treat them as ordered. […] Regularly perform physical assessments to identify signs and symptoms of heart failure. […] Before discharge, explain any activity limitations or diet restrictions and teach him how to recognize the signs and symptoms of heart failure. […] Tell him to contact his cardiologist or dial 911 immediately if symptoms worsen.

• #33 Myocarditis Treatment & Management: Approach Considerations, Emergency Department Care, Medical Care

  https://emedicine.medscape.com/article/156330-treatment

  Standard treatment of clinically significant disease includes the detection of dysrhythmia with cardiac monitoring, the administration of supplemental oxygen, and the management of fluid status. […] Left ventricular (LV) dysfunction developing from myocarditis should be approached in much the same manner as other causes of CHF, with some exceptions. In general, sympathomimetic drugs should be avoided, because they increase the extent of myocardial necrosis and mortality. Beta blockers should be avoided in the acutely decompensating phase of illness. […] Surgical care for patient with myocarditis is primarily recommended if medical treatment fails and if the patient is symptomatic. […] Fulminant myocarditis carries a low threshold for ventilatory and MCS (eg, intra-aortic balloon pump) because of the rapidly progressive course of decompensation and the potential for reversal.

• #34 Myocarditis: Causes, Symptoms, Treatment & Tests You May Need

  https://www.webmd.com/heart-disease/myocarditis

  Sometimes, mild myocarditis gets better on its own. But other times, you might need medical treatment. […] If possible, your doctor will treat the cause of the myocarditis (for example, by prescribing medications for lupus). […] Usually, youll be given medicines to help your heart work better. Examples include: ACE inhibitors. These lower your blood pressure so your heart doesnt have to work as hard. Beta-blockers. These slow down your heart rate and lower blood pressure. Corticosteroids. These calm down inflammation in the heart. Diuretics. These can help decrease fluid build-up caused by a weakened heart. Intravenous immunoglobulin. These are antibodies, or infection-fighting proteins, delivered through an IV. […] Your doctor will probably suggest rest or reduced activity. They might put you on a low-salt diet to keep fluid from building up. If you have mild myocarditis, it will often get better with just medication and rest.

• #35 Myocarditis: Symptoms and Causes

  https://my.clevelandclinic.org/health/diseases/22129-myocarditis

  Myocarditis is inflammation of the heart muscle, or myocardium. This inflammation weakens your heart muscle, making it harder for your heart to pump. This can be caused by viral infections or inflammatory conditions. […] Myocarditis is inflammation of your heart muscle (myocardium). This can weaken your heart muscle, making it more difficult for your heart to pump. This rare condition can affect people quickly or slowly over time. […] People with myocarditis often feel fatigued, short of breath, chest pain or the sensation of their heart racing (palpitations). […] If you have a mild case, it may go away on its own. If not, your provider can order medicines for you. […] To treat myocarditis, your healthcare provider may want you to take medication. These include: Medicines for heart failure, Corticosteroids, Intravenous (IV) immunoglobulin.

• #36 Understanding Myocarditis 

  https://www.veteranshealthlibrary.va.gov/RelatedItems/142,41700_VA

  Your health care team will treat the underlying cause of the myocarditis, such as an infection. In addition, you may be prescribed medicines to help your heart work better. You may be given any of these: Diuretic medicine, Beta blocker, ACE inhibitor, Medicine for abnormal rhythms, Corticosteroids, Blood thinner medicine. […] You will also need self-care that includes: A lot of rest, A low-salt diet, No NSAID medicines, such as ibuprofen, No alcohol, No smoking, No exercise for a while. […] You may need to be treated in the hospital if your condition is severe. Some people may need an implanted device to help control their heart rhythm. This may be a pacemaker or an implantable cardioverter-defibrillator (ICD). In rare cases, some people may require a mechanical heart pump or heart transplant.

• #37 Myocarditis Treatment & Management: Approach Considerations, Emergency Department Care, Medical Care

  https://emedicine.medscape.com/article/156330-treatment

  Following stabilization, it is recommended that all patients with fulminant myocarditis and contractile dysfunction regardless of the disease pathogenesis be treated with evidence-based neurohormonal antagonist therapy. […] Patients should consume a low-sodium diet similar to that for HF management. […] Following a diagnosis of myocarditis, expert consensus recommends 3 to 6 months of abstinence from competitive sports to lower the risk of remodeling and sudden death. […] Safety for return to strenuous physical activity is guided by a follow-up cardiac magnetic resonance imaging (CMRI), 24-hour monitoring for arrhythmia, and exercise testing, typically at 6 months after diagnosis.

• #38 Myocarditis | Montefiore Einstein Center for Heart & Vascular Care | Patient Care | Montefiore Einstein

  https://montefioreeinstein.org/heart/conditions/heart-failure-cardiomyopathies/myocarditis

  At the Montefiore Einstein Center for Heart and Vascular Care, you can access exceptional care for myocarditis. […] When you need myocarditis care, turn to our dedicated providers who will develop a highly personalized treatment plan specific to you. […] Your doctor may prescribe one or more medicines to treat heart inflammation, depending on the type and cause of heart inflammation. […] Corticosteroids to lower the activity of the body’s immune system. Corticosteroids may be used to treat myocarditis caused by autoimmune diseases, such as lupus. […] Your doctor may consider procedures and surgeries to treat your heart inflammation, including: Heart surgery to manage damage to valves or nearby heart tissue from endocarditis. […] Follow up with your doctors as instructed. Your exact follow-up will depend on the cause and severity of your disease. Ongoing medical care may include: Continuing all treatments as directed by your doctor. […] To prevent complications, it is important to take these steps: Continue all medicines as directed by your doctor, including those for complications such as heart failure or arrhythmias or for medical conditions that may have contributed to your endocarditis, myocarditis, or pericarditis.

• #39 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Myocarditis-Therapy.aspx

  In patients whose condition gets worse despite optimal medical management, mechanical circulatory support can be instituted in the form of ventricular assist devices or extracorporeal membrane oxygenation, for example. […] Temporary pacemaker insertion can be considered for affected individuals with symptomatic atrioventricular (AV) block II or III. […] Survival after heart transplantation for myocarditis is comparable to other causes of cardiac failure. […] Immunosuppression is a well-established treatment in giant cell myocarditis since it has been shown that patients with this condition had a significantly prolonged transplant-free survival when treated with prednisone and cyclosporine. […] This type of treatment regimen is also employed in hypersensitivity myocarditis, as well as in myocarditis associated with systemic diseases like sarcoidosis and lupus erythematosus.

• #40 Myocarditis in Children | Children’s Hospital Los Angeles

  https://www.chla.org/myocarditis-children

  Our pediatric cardiologists see children with myocarditis symptoms on short notice. We perform a thorough assessment that includes specialized testing to confirm or rule out myocarditis. These efforts help your child receive timely care that lowers the risk of permanent heart damage. […] If its safe for your child to recover at home, we provide detailed care instructions. Our experts explain how to keep your child comfortable and teach you the signs of complications to look out for. […] We offer the full range of heart failure therapies to the small number of children who experience severe myocarditis. Your childs care may include medication drips, breathing machines (ventilators), extracorporeal membrane oxygenation (ECMO) or ventricular assist devices (VADs), which are implantable devices that help the heart do its job.

• #41 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Myocarditis-Therapy.aspx

  In patients whose condition gets worse despite optimal medical management, mechanical circulatory support can be instituted in the form of ventricular assist devices or extracorporeal membrane oxygenation, for example. […] Temporary pacemaker insertion can be considered for affected individuals with symptomatic atrioventricular (AV) block II or III. […] Survival after heart transplantation for myocarditis is comparable to other causes of cardiac failure. […] Immunosuppression is a well-established treatment in giant cell myocarditis since it has been shown that patients with this condition had a significantly prolonged transplant-free survival when treated with prednisone and cyclosporine. […] This type of treatment regimen is also employed in hypersensitivity myocarditis, as well as in myocarditis associated with systemic diseases like sarcoidosis and lupus erythematosus.

• #42 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Myocarditis-Therapy.aspx

  In patients whose condition gets worse despite optimal medical management, mechanical circulatory support can be instituted in the form of ventricular assist devices or extracorporeal membrane oxygenation, for example. […] Temporary pacemaker insertion can be considered for affected individuals with symptomatic atrioventricular (AV) block II or III. […] Survival after heart transplantation for myocarditis is comparable to other causes of cardiac failure. […] Immunosuppression is a well-established treatment in giant cell myocarditis since it has been shown that patients with this condition had a significantly prolonged transplant-free survival when treated with prednisone and cyclosporine. […] This type of treatment regimen is also employed in hypersensitivity myocarditis, as well as in myocarditis associated with systemic diseases like sarcoidosis and lupus erythematosus.

• #43

  https://journals.lww.com/nursing/fulltext/2004/10000/muscle_up_your_knowledge_of_myocarditis.12.aspx

  AN INFLAMMATION of the myocardium, myocarditis is typically triggered by an enterovirus such as coxsackievirus, although many other possible causes have been identified. […] Although myocarditis is usually mild and self-limiting, it can lead to arrhythmias, pericarditis, chronic dilated cardiomyopathy, and heart failure. […] Treatment for myocarditis depends on the underlying cause. Supportive care includes bed rest and avoiding strenuous exercise until the ECG returns to normal. […] Keep the patient on bed rest to decrease the heart’s workload. […] Closely monitor him for arrhythmias and treat them as ordered. […] Regularly perform physical assessments to identify signs and symptoms of heart failure. […] Before discharge, explain any activity limitations or diet restrictions and teach him how to recognize the signs and symptoms of heart failure. […] Tell him to contact his cardiologist or dial 911 immediately if symptoms worsen.

• #44 Myocarditis: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/myocarditis/?srsltid=AfmBOoreyuCfyEGsmlzR3tpBD16JlQPC9P-cdOZI9aijEc3bgK9vGL05

  Completes activities of daily living without becoming fatigued. […] Demonstrates decreased anxiety. […] Demonstrates effective coping. […] Condition, treatment, and outcomes. […] Review medications and side effects. […] Follow up with healthcare provider or specialist. […] Review importance of reducing the workload on the heart. […] Avoid alcohol and smoking. […] Up-to-date vaccinations. […] Notify healthcare provider or seek medical attention for: Chest pain, Fever, Shortness of breath, Influenza-like symptoms.

• #45 Nursing Care Plan for Myocarditis | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-myocarditis

  Nursing Care Plan (NCP) for Myocarditis […] Upon completion of this nursing care plan for Myocarditis, nursing students will be able to: […] Provide in-depth nursing care for patients with myocarditis, focusing on understanding the pathophysiology, etiology, clinical manifestations, and management strategies. This plan emphasizes the importance of timely recognition, appropriate treatment, patient education, and support in managing this condition. […] Desired Outcomes for Myocarditis […] Patient understanding of the condition and its management. […] Nursing Diagnosis for Myocarditis […] Knowledge Deficit regarding disease management and lifestyle modifications. […] Nursing Interventions and Rationales for Myocarditis […] Patient Education: Educate about the importance of medication adherence, lifestyle changes, and recognizing worsening symptoms. […] Rationale: To empower the patient in managing their condition and preventing complications. […] Evaluation for Myocarditis […] Evaluate understanding of myocarditis and self-management skills.

• #46 Myocarditis: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.myocarditis-care-instructions.acd5230

  Myocarditis is inflammation of the heart muscle. Treatment depends on how severe the illness is. If you have other heart problems, your doctor will treat them at the same time. You may need to take medicine for your heart. Lifestyle changes such as getting more rest, reducing salt in your diet, avoiding alcohol, and quitting smoking may be part of the treatment. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you’re having a problem with your medicine. […] Have a heart-healthy lifestyle. Eat heart-healthy foods. This includes vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit sodium, alcohol, and sugar. […] Be sure to go to all follow-up appointments and tests that your doctor recommends. […] Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

• #47

  https://journals.lww.com/nursing/fulltext/2004/10000/muscle_up_your_knowledge_of_myocarditis.12.aspx

  AN INFLAMMATION of the myocardium, myocarditis is typically triggered by an enterovirus such as coxsackievirus, although many other possible causes have been identified. […] Although myocarditis is usually mild and self-limiting, it can lead to arrhythmias, pericarditis, chronic dilated cardiomyopathy, and heart failure. […] Treatment for myocarditis depends on the underlying cause. Supportive care includes bed rest and avoiding strenuous exercise until the ECG returns to normal. […] Keep the patient on bed rest to decrease the heart’s workload. […] Closely monitor him for arrhythmias and treat them as ordered. […] Regularly perform physical assessments to identify signs and symptoms of heart failure. […] Before discharge, explain any activity limitations or diet restrictions and teach him how to recognize the signs and symptoms of heart failure. […] Tell him to contact his cardiologist or dial 911 immediately if symptoms worsen.

• #48

  https://journals.lww.com/nursing/fulltext/2004/10000/muscle_up_your_knowledge_of_myocarditis.12.aspx

  AN INFLAMMATION of the myocardium, myocarditis is typically triggered by an enterovirus such as coxsackievirus, although many other possible causes have been identified. […] Although myocarditis is usually mild and self-limiting, it can lead to arrhythmias, pericarditis, chronic dilated cardiomyopathy, and heart failure. […] Treatment for myocarditis depends on the underlying cause. Supportive care includes bed rest and avoiding strenuous exercise until the ECG returns to normal. […] Keep the patient on bed rest to decrease the heart’s workload. […] Closely monitor him for arrhythmias and treat them as ordered. […] Regularly perform physical assessments to identify signs and symptoms of heart failure. […] Before discharge, explain any activity limitations or diet restrictions and teach him how to recognize the signs and symptoms of heart failure. […] Tell him to contact his cardiologist or dial 911 immediately if symptoms worsen.

• #49 Myocarditis Recovery and Rehabilitation | LifeMD

  https://lifemd.com/learn/myocarditis-recovery-and-rehabilitation

  Most patients successfully recover from myocarditis, but it may take up to seven years for a complete recovery. […] Patients can aid their recovery by staying hydrated, getting plenty of rest, and following a low-sodium diet. […] Physical therapy or cardiac rehabilitation programs can help you recover effectively. […] If you have severe myocarditis that weakens the heart muscle and affects your physical function, you may need to work with a physical therapist during your recovery. […] Physical therapists can help myocarditis patients by safely increasing their usual activity level, gradually improving their cardiovascular fitness, and helping them regain their strength without excessively straining the heart. […] There are also cardiac rehabilitation programs that your doctor may recommend.

• #50 Myocarditis Recovery and Rehabilitation | LifeMD

  https://lifemd.com/learn/myocarditis-recovery-and-rehabilitation

  Most patients successfully recover from myocarditis, but it may take up to seven years for a complete recovery. […] Patients can aid their recovery by staying hydrated, getting plenty of rest, and following a low-sodium diet. […] Physical therapy or cardiac rehabilitation programs can help you recover effectively. […] If you have severe myocarditis that weakens the heart muscle and affects your physical function, you may need to work with a physical therapist during your recovery. […] Physical therapists can help myocarditis patients by safely increasing their usual activity level, gradually improving their cardiovascular fitness, and helping them regain their strength without excessively straining the heart. […] There are also cardiac rehabilitation programs that your doctor may recommend.

• #51 Myocarditis Recovery and Rehabilitation | LifeMD

  https://lifemd.com/learn/myocarditis-recovery-and-rehabilitation

  Before resuming exercise, you should consult your doctor, as physical activity strains the heart muscle. […] As a general rule, physical activity should be avoided for at least three to six months after being diagnosed with myocarditis. […] Resting is crucial for recovery from myocarditis, as it reduces the heart’s workload and aids in healing. […] Adequate rest is also vital for supporting the immune system, which is essential for combating infection. […] If you are receiving myocarditis treatment, such as medications to lower your blood pressure and reduce heart muscle inflammation, you must continue your treatment as prescribed. […] Proper hydration can help the heart muscle to function and pump blood more effectively. […] Those recovering from myocarditis should focus on a diet rich in fruits and vegetables, which provide essential nutrients needed for healing and recovery.

• #52 Myocarditis Recovery and Rehabilitation | LifeMD

  https://lifemd.com/learn/myocarditis-recovery-and-rehabilitation

  You should also take steps to lower your sodium intake and unhealthy fats, as this can put strain on the heart and potentially worsen your symptoms. […] Keeping track of your myocarditis symptoms is important during your recovery. […] If certain symptoms persist, your healthcare provider may adjust your medications. […] Joining a support group can make you feel less alone in your journey to recovery. […] Working with a psychologist or counselor can provide the emotional support needed during the recovery process.

• #53 Myocarditis Recovery and Rehabilitation | LifeMD

  https://lifemd.com/learn/myocarditis-recovery-and-rehabilitation

  Before resuming exercise, you should consult your doctor, as physical activity strains the heart muscle. […] As a general rule, physical activity should be avoided for at least three to six months after being diagnosed with myocarditis. […] Resting is crucial for recovery from myocarditis, as it reduces the heart’s workload and aids in healing. […] Adequate rest is also vital for supporting the immune system, which is essential for combating infection. […] If you are receiving myocarditis treatment, such as medications to lower your blood pressure and reduce heart muscle inflammation, you must continue your treatment as prescribed. […] Proper hydration can help the heart muscle to function and pump blood more effectively. […] Those recovering from myocarditis should focus on a diet rich in fruits and vegetables, which provide essential nutrients needed for healing and recovery.

• #54 Myocarditis Recovery and Rehabilitation | LifeMD

  https://lifemd.com/learn/myocarditis-recovery-and-rehabilitation

  Before resuming exercise, you should consult your doctor, as physical activity strains the heart muscle. […] As a general rule, physical activity should be avoided for at least three to six months after being diagnosed with myocarditis. […] Resting is crucial for recovery from myocarditis, as it reduces the heart’s workload and aids in healing. […] Adequate rest is also vital for supporting the immune system, which is essential for combating infection. […] If you are receiving myocarditis treatment, such as medications to lower your blood pressure and reduce heart muscle inflammation, you must continue your treatment as prescribed. […] Proper hydration can help the heart muscle to function and pump blood more effectively. […] Those recovering from myocarditis should focus on a diet rich in fruits and vegetables, which provide essential nutrients needed for healing and recovery.

• #55 Myocarditis: Causes, Symptoms, Treatment & Tests You May Need

  https://www.webmd.com/heart-disease/myocarditis

  Your outlook depends on: The cause of your myocarditis, Your overall health, Complications you have, if any. […] Many people recover completely, with no complications or long-term damage. Others have chronic myocarditis. Either way, follow-up care can help keep track of any ongoing problems. It’s also important to know that myocarditis can come back, although its not common. […] There are many ways to take care of your heart. Here are some tips: Limit the amount of salt you eat. Avoid drinking. Dont smoke. Dont exercise until your doctor says its okay. Ask your doctor if you need to limit the amount of liquid you drink. Keep in touch with your doctor. Take your medicines as prescribed, schedule regular follow-up appointments, and get suggested follow-up tests. […] Its important to continue these healthy habits even after myocarditis has gone away.

• #56

  https://journals.lww.com/nursing/fulltext/2004/10000/muscle_up_your_knowledge_of_myocarditis.12.aspx

  AN INFLAMMATION of the myocardium, myocarditis is typically triggered by an enterovirus such as coxsackievirus, although many other possible causes have been identified. […] Although myocarditis is usually mild and self-limiting, it can lead to arrhythmias, pericarditis, chronic dilated cardiomyopathy, and heart failure. […] Treatment for myocarditis depends on the underlying cause. Supportive care includes bed rest and avoiding strenuous exercise until the ECG returns to normal. […] Keep the patient on bed rest to decrease the heart’s workload. […] Closely monitor him for arrhythmias and treat them as ordered. […] Regularly perform physical assessments to identify signs and symptoms of heart failure. […] Before discharge, explain any activity limitations or diet restrictions and teach him how to recognize the signs and symptoms of heart failure. […] Tell him to contact his cardiologist or dial 911 immediately if symptoms worsen.

• #57 Myocarditis Causes, Symptoms, and Treatments

  https://www.upmc.com/services/heart-vascular/conditions/myocarditis

  Myocarditis is a rare disease that causes the heart muscle to become inflamed. […] It weakens the heart muscle and makes it harder for the heart to pump. […] Myocarditis is an inflammation of the heart muscle (the myocardium), often caused by a virus or autoimmune disease. […] It can weaken the heart, making it harder to pump blood. […] Myocarditis is a rare disease and can be mild or severe. […] In the worst cases, it can lead to: Heart failure. Abnormal heart rhythms. Shock. Sudden death. […] Myocarditis can affect all age groups, including children but occurs more often in young adults. […] Myocarditis caused by autoimmune disease is more common in women, and the other types are more common in men. […] Your doctor may prescribe one or more of these medications to help treat your myocarditis: Corticosteroids. These drugs can calm the body’s immune system if an autoimmune disease triggered myocarditis.

• #58 Myocarditis Types, Symptoms and Prevention

  https://larkinhealth.com/en/treatments-services/cardiology/myocarditis/

  Myocarditis is a condition characterized by inflammation of the myocardium (heart muscle), resulting in hampering the ability of the heart to pump blood. […] Treatment options for myocarditis may include surgeries or medications. […] Some patients with myocarditis may cause symptoms such as fatigue, shortness of breath, and inability to endure exercise. […] Myocarditis is known to be the primary cause of about 5-10% of sudden cardiac deaths in athletes. […] Some medical recommendations for treating myocarditis include rest from exercise (3-4 months) and frequent testing to determine normal cardiac function. […] After treatment, many patients live happy, healthy life. Some patients may need regular cardiovascular medication under the guidance of a specialist or even a heart transplant depending on the severity of the condition.

• #59 Nursing Considerations for ICI-Related Myocarditis | Oncology Nursing Society

  https://www.ons.org/news-and-views/nursing-considerations-for-ici-related-myocarditis

  Before immunotherapies like immune checkpoint inhibitors (ICIs) became a cancer treatment option, myocarditis typically developed in the presence of infections, drug allergies, or autoimmune diseases. […] In their article in the February 2022 issue of the Clinical Journal of Oncology Nursing, Kuhnly and Coviello analyzed and consolidated the evidence for oncology nurses to recognize, monitor, and manage patients with cancer who are experiencing ICI-related myocarditis. […] ICI-related myocarditis occurs in about 0.4%1.14% of patients, Kuhnly and Coviello reported, but mortality rates range from 25%50% despite treatment intervention. […] Patients may be asymptomatic or experience severe symptoms according to the Common Terminology Criteria for Adverse Events scale: […] Significant arrhythmias occur in 19% of patients with ICI-related myocarditis, most commonly complete heart block.

• #60 Myocarditis in Children | Symptoms, Causes, Treatment & Prognosis

  https://www.cincinnatichildrens.org/health/m/myocarditis

  The good news is that about two-thirds of the children, with the right medical management, will have a complete recovery. If untreated, only 10 percent to 20 percent will have recovery on their own, and 80 percent will develop chronic heart disease. For most children, recovery usually occurs within two to three months from the onset of the illness.

• #61 Myocarditis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/244

  Myocarditis describes a heterogeneous group of disorders characterised by myocardial inflammation in the absence of predominant acute or chronic ischaemia. […] Treatment is usually supportive care and conventional heart failure therapy. More severe presentations may need aggressive pharmacological treatment with escalation to mechanical circulatory support. Occasionally, some cases do not respond to conventional therapy and progress to heart transplantation or death. […] Prognosis is variable but is related to presentation and underlying aetiology. Most cases of viral myocarditis are asymptomatic and spontaneously resolve. Patients who present with mild to moderate heart failure tend to improve or recover but may progress to chronic severe heart failure. Surprisingly, patients who present with fulminant, acutely decompensated heart failure almost universally recover back to baseline function, if death is prevented through management in the acute phase.

• #62 Myocarditis: Causes, Symptoms, Treatment & Tests You May Need

  https://www.webmd.com/heart-disease/myocarditis

  Your outlook depends on: The cause of your myocarditis, Your overall health, Complications you have, if any. […] Many people recover completely, with no complications or long-term damage. Others have chronic myocarditis. Either way, follow-up care can help keep track of any ongoing problems. It’s also important to know that myocarditis can come back, although its not common. […] There are many ways to take care of your heart. Here are some tips: Limit the amount of salt you eat. Avoid drinking. Dont smoke. Dont exercise until your doctor says its okay. Ask your doctor if you need to limit the amount of liquid you drink. Keep in touch with your doctor. Take your medicines as prescribed, schedule regular follow-up appointments, and get suggested follow-up tests. […] Its important to continue these healthy habits even after myocarditis has gone away.

• #63 Myocarditis: Causes, Symptoms, Treatment & Tests You May Need

  https://www.webmd.com/heart-disease/myocarditis

  Your outlook depends on: The cause of your myocarditis, Your overall health, Complications you have, if any. […] Many people recover completely, with no complications or long-term damage. Others have chronic myocarditis. Either way, follow-up care can help keep track of any ongoing problems. It’s also important to know that myocarditis can come back, although its not common. […] There are many ways to take care of your heart. Here are some tips: Limit the amount of salt you eat. Avoid drinking. Dont smoke. Dont exercise until your doctor says its okay. Ask your doctor if you need to limit the amount of liquid you drink. Keep in touch with your doctor. Take your medicines as prescribed, schedule regular follow-up appointments, and get suggested follow-up tests. […] Its important to continue these healthy habits even after myocarditis has gone away.

• #64 Myocarditis in Children | Symptoms, Causes, Treatment & Prognosis

  https://www.cincinnatichildrens.org/health/m/myocarditis

  Myocarditis is a condition where the muscular walls of the heart become inflamed. Myocarditis typically results in poor heart function. […] Treatment for myocarditis is based on how badly the heart is affected. Many children have a complete recovery, but some may develop serious heart failure and require chronic care from a cardiologist. […] The inflammation in the heart muscle will usually go away on its own. There is no cure for myocarditis. In general, the goal of medical therapy is to support the heart function so that adequate blood circulation is maintained. Most children diagnosed with myocarditis are admitted to an intensive care unit for initial management and careful monitoring. […] Most children diagnosed with myocarditis are admitted to an intensive care unit for initial management. It is important for the child to be placed on bed rest. There is evidence to suggest that strenuous activity may be harmful to the heart during the recovery period. Depending upon the severity of the myocarditis, this may mean that physical activity is restricted for weeks to months. The child’s physical activity should be slowly increased over time.

• #65 Myocarditis in Children | Children’s Hospital Los Angeles

  https://www.chla.org/myocarditis-children

  Myocarditis is a rare disease affecting heart tissue. Most children with myocarditis do not need to stay in the hospital and go on to make a full recovery. But a small number of children end up with severe heart issues. At Childrens Hospital Los Angeles, our trusted pediatric experts excel in caring for this condition. […] We offer the highest level of myocarditis treatment, including specialized inpatient services in our Cardiothoracic Intensive Care Unit. Nationally recognized pediatric cardiologists and other specialists quickly pinpoint the source of your childs symptoms. We then tailor therapies that offer the best chances for healing. […] Signs of myocarditis include chest pain and shortness of breath. These are medical emergencies that require immediate care. […] Childrens Hospital Los Angeles is one of the top 10 childrens hospitals in the nation, according to U.S. News World Report. We are experts in rare and potentially serious conditions like myocarditis. You can count on us for an accurate diagnosis and leading therapies for your child.

• #66 Myocarditis in Children | Children’s Hospital Los Angeles

  https://www.chla.org/myocarditis-children

  Our pediatric cardiologists see children with myocarditis symptoms on short notice. We perform a thorough assessment that includes specialized testing to confirm or rule out myocarditis. These efforts help your child receive timely care that lowers the risk of permanent heart damage. […] If its safe for your child to recover at home, we provide detailed care instructions. Our experts explain how to keep your child comfortable and teach you the signs of complications to look out for. […] We offer the full range of heart failure therapies to the small number of children who experience severe myocarditis. Your childs care may include medication drips, breathing machines (ventilators), extracorporeal membrane oxygenation (ECMO) or ventricular assist devices (VADs), which are implantable devices that help the heart do its job.

• #67 Anakinra in pediatric acute fulminant myocarditis | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-022-01054-0

  Acute fulminant myocarditis in children is associated with elevated mortality and morbidity with few advances in its medical management. […] Here we report a preliminary experience of children treated with IL-1 receptor antagonist associated with rapid myocardial function recovery. […] In this pilot study, use of IL-1 receptor antagonist in the initial treatment of acute fulminant myocarditis in children seems to be associated with rapid stabilization and recovery. […] Anakinra, an IL-1 receptor antagonist, is shown to be safe and may provide a novel approach to treat fulminant acute myocarditis in children. […] Our retrospective case series supports further investigation of the role for IL-1 receptor antagonist in the treatment of pediatric acute and fulminant myocarditis. All patients had rapid response to anakinra on contractile dysfunction and cardiac enzymes. Given its safety and rapid onset of action, anakinra may have a place in the pediatric myocarditis treatment.

• #68 Nursing Considerations for ICI-Related Myocarditis | Oncology Nursing Society

  http://www.ons.org/news-and-views/nursing-considerations-for-ici-related-myocarditis

  Before immunotherapies like immune checkpoint inhibitors (ICIs) became a cancer treatment option, myocarditis typically developed in the presence of infections, drug allergies, or autoimmune diseases. […] Nursing Considerations for ICI-Related Myocarditis […] Kuhnly and Coviello analyzed and consolidated the evidence for oncology nurses to recognize, monitor, and manage patients with cancer who are experiencing ICI-related myocarditis. […] ICI-related myocarditis occurs in about 0.4%1.14% of patients, Kuhnly and Coviello reported, but mortality rates range from 25%50% despite treatment intervention. […] Patients may be asymptomatic or experience severe symptoms according to the Common Terminology Criteria for Adverse Events scale: […] Instruct patients to report the following signs and symptoms right away:

• #69 Nursing Considerations for ICI-Related Myocarditis | Oncology Nursing Society

  http://www.ons.org/news-and-views/nursing-considerations-for-ici-related-myocarditis

  Patients at higher risk are referred to cardio-oncology for a cardiovascular pretreatment assessment, and all patients receiving combination ICIs should complete a standard follow-up visit during the early phases of therapy, Kuhnly and Coviello said. […] If a patient begins experiencing myocarditis symptoms during ICI treatment, consult with cardio-oncology for evaluation and hold ICI therapy until diagnosis. […] If cardio-oncology confirms a high suspicion or diagnosis of myocarditis, continue the steroids and taper for at least four to six weeks. […] Little research is available about restarting ICIs after a patient recovers from myocarditis Kuhnly and Coviello said. If patients resume ICI therapy, they advised close cardiac monitoring throughout treatment.

• #70 Nursing Considerations for ICI-Related Myocarditis | Oncology Nursing Society

  http://www.ons.org/news-and-views/nursing-considerations-for-ici-related-myocarditis

  Patients at higher risk are referred to cardio-oncology for a cardiovascular pretreatment assessment, and all patients receiving combination ICIs should complete a standard follow-up visit during the early phases of therapy, Kuhnly and Coviello said. […] If a patient begins experiencing myocarditis symptoms during ICI treatment, consult with cardio-oncology for evaluation and hold ICI therapy until diagnosis. […] If cardio-oncology confirms a high suspicion or diagnosis of myocarditis, continue the steroids and taper for at least four to six weeks. […] Little research is available about restarting ICIs after a patient recovers from myocarditis Kuhnly and Coviello said. If patients resume ICI therapy, they advised close cardiac monitoring throughout treatment.

• #71 Myocarditis Treatment & Management: Approach Considerations, Emergency Department Care, Medical Care

  https://emedicine.medscape.com/article/156330-treatment

  Overall, neurohormonal agents are given in a similar manner as in patients presenting with new-onset HF. Serial assessment is needed to determine the potential resolution of acute myocarditis, and during the early recovery period, strenuous exercise and digoxin should be avoided. Data regarding the risks of relapse with drug withdrawal following recovery are not available, so it is generally not recommended in practice. […] Risk stratification in patients with symptomatic myocarditis guides the decision whether to refer to an advanced HF center with a multidisciplinary myocarditis team. There should be a low threshold to transfer patients with high-risk features, such as severely reduced ventricular function, symptomatic HF, hemodynamic instability, or electrical instability (either ventricular arrhythmias or heart block).

• #72 Myocarditis in Children Requiring Critical Care Transport | IntechOpen

  https://www.intechopen.com/chapters/43485

  Myocarditis is an uncommon but potentially life-threatening presentation in pediatric patients requiring critical care transport. Patients may present with malignant arrhythmias and hemodynamic collapse, and may require transport to a center offering extracorporeal life support. […] In this chapter we aim to provide a brief overview of pediatric myocarditis, with a particular focus on considerations for stabilization and transport in acute fulminant myocarditis. These considerations include intubation and ventilation, hemodynamic support, induction of anesthesia and pharmacological considerations for sedation, patient triage, and choice of an appropriate receiving center. […] Pediatric patients with symptomatic myocarditis should be admitted to a pediatric tertiary care center. […] When triaging the patient, consideration should be given to the fact that any patient requiring the use of blood pressure support in the setting of acute myocarditis may quickly deteriorate and need mechanical cardiovascular support. Extracorporeal membrane oxygenation (ECMO) support is now increasingly viewed as optimal supportive therapy in anticipation of full cardiac recovery.

• #73 Myocarditis in Children Requiring Critical Care Transport | IntechOpen

  https://www.intechopen.com/chapters/43485

  For transport purposes intubation, ventilation and inotropic support play a larger role than other support strategies. […] In general, positive pressure ventilation reduces left ventricular wall tension and left ventricular afterload, and therefore may improve cardiac output by this mechanism. […] The choice of the appropriate medication for induction of anesthesia for intubation is important. […] The adverse hemodynamic effects of positive pressure ventilation on right sided venous return may be ameliorated by using a strategy to minimize mean airway pressure, thus reducing intrathoracic pressure. […] In summary, choosing a team and mode of transport for a patient is complex. […] Myocarditis presents with a broad range of relatively non-specific symptoms and for that reason is difficult to diagnose, but must remain on the list of differential diagnoses for any child presenting with acute heart failure or other signs of cardiac deterioration. Acute fulminant myocarditis is life-threatening and requires careful, proactive management. When treating the pediatric patient with acute fulminant myocarditis clinicians should consider the benefits of intubation, inotropic infusions, and transcutaneous pacing as temporizing measures especially during the transport phase, recognizing that any of those interventions can lead to further deterioration of the patient if not performed with great caution. Prompt and safe transport to a pediatric tertiary care center should be ensured. The option of early management with ECMO or other assist devices seems beneficial and should be considered when making triage decisions.

• #74 Strategies and Criteria for the Diagnosis and Management of Myocarditislogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na58268/2024/12/24/strategies-and-criteria-diagnosis-and-management

  A proposed 5-step care pathway: […] Treatment linked to disease stage and etiology […] A 4-stage classification of myocarditis is defined, with stages linked to treatment strategies and supportive care. The stages are: 1. exposure to risk factors; 2. asymptomatic myocarditis; 3. symptomatic myocarditis; 4. advanced myocarditis, with hemodynamic or electrical instability […] An integrated multidisciplinary myocarditis team present at advanced heart failure centers is advised for management of patients with severe clinical features.

• #75 What Is Myocarditis? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/myocarditis/guide/

  Myocarditis can affect the hearts muscle and electrical system, reducing the hearts ability to pump properly, potentially leading to a number of complications, according to the Mayo Clinic. […] In some cases, myocarditis goes away on its own. In other cases, treatment may include: […] If your heart muscle has become weakened, you might be prescribed one of the following medications to help reduce its workload: […] Severe cases of myocarditis may need to be treated with medical procedures, including: […] There is no specific way to prevent myocarditis, but there are steps you can take to prevent infections that might lead to the condition. […] In these instances, myocarditis is part of a more widespread issue and may require treatment with immunosuppressive medication.

• #76 Myocarditis | PPT

  https://www.slideshare.net/slideshow/myocarditis-233464476/233464476

  Management:- The patient receives specific treatment for the underlying cause if it is known (eg, penicillin for hemolytic streptococci) and is placed on bed rest to decrease the cardiac workload. Bed rest- helps to decrease myocardial damage and the complications of myocarditis. Physical activity should be limited for a 6 month period ar atleast until heart size and function have returned to normal. For patients with moderate to severe dysfunction, cardiac function can be supported use of : i. Antibiotics ii. Antiviral interferon A iii. Oral therapy with ACE inhibitors (Captopril, Lisinopril) iv. Digoxin v. Diuretics vi. Oxygen therapy vii. Corticosteroids or immunosuppressents Heart transplant. […] Prevention of infectious disease by means of appropriate immunizations (eg, influenza, hapatitis). Early and prompt treatment to decrease the incidence of myocarditis.

• #77 Association Between COVID-19 and Myocarditis Using Hospital-Based Administrative Data — United States, March 2020–January 2021 | MMWR

  https://www.cdc.gov/mmwr/volumes/70/wr/mm7035e5.htm

  Viral infections are a common cause of myocarditis. Some studies have indicated an association between COVID-19 and myocarditis. […] During March 2020January 2021, patients with COVID-19 had nearly 16 times the risk for myocarditis compared with patients who did not have COVID-19, and risk varied by sex and age. […] Overall, myocarditis was uncommon among persons with and without COVID-19; however, COVID-19 was significantly associated with an increased risk for myocarditis, with risk varying by age group. […] Myocarditis is uncommon among patients with and without COVID-19; however, COVID-19 is a strong and significant risk factor for myocarditis, with risk varying by age group. The findings in this report underscore the importance of implementing evidence-based COVID-19 prevention strategies, including vaccination, to reduce the public health impact of COVID-19 and its associated complications.

• #78 Association Between COVID-19 and Myocarditis Using Hospital-Based Administrative Data — United States, March 2020–January 2021 | MMWR

  https://www.cdc.gov/mmwr/volumes/70/wr/mm7035e5.htm

  Viral infections are a common cause of myocarditis. Some studies have indicated an association between COVID-19 and myocarditis. […] During March 2020January 2021, patients with COVID-19 had nearly 16 times the risk for myocarditis compared with patients who did not have COVID-19, and risk varied by sex and age. […] Overall, myocarditis was uncommon among persons with and without COVID-19; however, COVID-19 was significantly associated with an increased risk for myocarditis, with risk varying by age group. […] Myocarditis is uncommon among patients with and without COVID-19; however, COVID-19 is a strong and significant risk factor for myocarditis, with risk varying by age group. The findings in this report underscore the importance of implementing evidence-based COVID-19 prevention strategies, including vaccination, to reduce the public health impact of COVID-19 and its associated complications.

• #79 Questions to Ask

  http://www.cardiosmart.org/topics/myocarditis/questions-to-ask

  If you have myocarditis, make sure to ask questions so that you understand why your heart is inflamed and what you can do. […] What treatments can help prevent permanent damage or scarring to the heart muscle? […] Should I stay away from certain activities or exercises? For how long? […] Are there foods I should avoid? […] I’ve heard myocarditis can come back. How likely is that to happen?

• #80 Myocarditis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/myocarditis/diagnosis-treatment/drc-20352544

  If you have symptoms of myocarditis, make an appointment for a health checkup. If symptoms are severe, you may first be seen in an emergency setting. You usually are sent to a doctor trained in heart diseases, called a cardiologist. You also may see a doctor trained in infectious disease. […] Don’t hesitate to ask other questions. Take a family member or friend along to your appointment, if possible, to help you remember the information you receive.

• #81 Myocarditis in Children | Children’s Hospital Los Angeles

  https://www.chla.org/myocarditis-children

  Children who recover from myocarditis may still experience heart issues, including abnormal heart rhythms (arrhythmias), as they get older. We develop personalized monitoring plans that include imaging tests, like cardiac magnetic resonance image (MRI). This approach helps us detect changes in heart functioning before they become serious. […] Severe myocarditis symptoms can become life-threatening, which is why the safest place for your child is our CTICU. A specialized team of doctors and nurses provides around-the-clock care and monitoring. […] Pediatric cardiologists work with other CHLA specialists to determine whats causing myocarditis and how best to treat it. Your childs care team may include experts from Infectious Diseases, Rheumatology and more. […] A sudden, severe illness like myocarditis can be difficult on your child and family. […] The extended care team includes social workers and Child Life specialists who ease the stress you are experiencing. Nurse coordinators manage the small details of your childs care so you can focus on healing.

• #82 Myocarditis (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/myocarditis.html

  Myocarditis is when this muscle gets inflamed (swollen). […] Most children recover fully from myocarditis within a few months. Sometimes, it can take a few years for the heart to fully recover. […] A pediatric cardiologist (a doctor who treats heart problems in children) cares for kids with myocarditis. Treatment depends on the cause and how sick the child is. It can include medicines and treatments to: […] Some kids will need care in a pediatric or cardiac intensive care unit (PICU/CICU). […] Over time, most children with myocarditis recover fully. Children who do have lasting heart problems may need to take medicines and/or avoid some physical activities. With the care of a cardiologist, they can find physical activity that works for them and live an active, full life. […] To help your child get the best care possible: Give medicines as directed by the doctor. Go to all follow-up doctor visits. Help your child do activities the care team told you are safe and avoid those that are risky. […] If your child has a long-term heart condition, it can feel overwhelming. But you’re not alone. To find support, talk to anyone on the care team. Resources are available to help you and your child.

Zobacz więcej