Materiały źródłowe

• #1 Myocarditis: Etiology, Pathogenesis, and Their Implications in Clinical Practice

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10295542/

  Myocarditis is an inflammatory disease of the myocardium caused by infectious or non-infectious agents. It is caused by a variety of infectious (i.e., viruses, bacteria, fungi, parasites) and non-infectious (i.e., organ-specific or systemic immune-mediated disease, drugs, vaccines, toxins) factors. Currently, viral etiology is considered to be the most common in western countries, even though the pathogenic role of certain types of viruses has been questioned. […] The etiopathogenesis of myocarditis is complex as it is caused by a variety of infectious and non-infectious factors. […] Myocarditis is thought to occur more frequently in males and at a young age. […] The understanding of myocarditis has greatly improved in recent years, but many questions still remain to be answered. […] The therapeutic significance and prognostic utility of etiopathogenesis, patients genetic background and mechanisms participating in the immune response are still not entirely understood.

• #2 Myocarditis: Etiology, Pathogenesis, and Their Implications in Clinical Practice

  https://www.mdpi.com/2079-7737/12/6/874

  Myocarditis is an inflammatory disease of the myocardium caused by infectious or non-infectious agents. It is caused by infectious and non-infectious factors; however, our understanding of processes that govern its pathogenesis is limited. The etiopathogenesis of myocarditis is complex as it is caused by a variety of infectious (i.e., viruses, bacteria, fungi, parasites) and non-infectious (i.e., organ-specific or systemic immune-mediated disease, drugs, vaccines, toxins) factors. Currently, viral etiology is considered to be the most common in western countries, even though the pathogenic role of certain types of viruses has been questioned. Myocarditis is thought to occur more frequently in males and at a young age. […] Management of myocarditis poses a major challenge to clinicians due to the heterogeneity in clinical presentation, infrequent use of endomyocardial biopsy (EMB), which is the diagnostic gold standard, and limited treatment options supported by suboptimal evidence.

• #3 Myocarditis: Background, Etiology, Pathophysiology

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

  Causes of myocarditis include: […] Viral: Enterovirus, coxsackie B, adenovirus, influenza, cytomegalovirus (CMV), poliomyelitis, Epstein-Barr virus (EBV), human immunodeficiency virus type 1 (HIV-1), viral hepatitis, mumps, rubeola, varicella, variola/vaccinia, arbovirus, respiratory syncytial virus (RSV), herpes simplex virus (HSV), yellow fever virus, rabies, parvovirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). […] Approximately 50% of the time, myocarditis is classified as idiopathic, although a report by Klugman et al found that 82% of the pediatric cases studied were considered idiopathic. […] In idiopathic cases, a viral etiology is often suspected but unproved, even with sophisticated immunohistochemical and genomic studies.

• #4 Myocarditis: Symptoms and Treatment for Inflammation of the Heart

  https://www.healthline.com/health/heart-disease/myocarditis

  Myocarditis refers to inflammation of your heart muscle. Its often caused by a bacterial or viral infection. […] Many times, the exact cause of myocarditis isnt known. In fact, its estimated that the cause of an acute case of myocarditis is unknown 50 percent of the time. This is called idiopathic myocarditis. […] When the cause of myocarditis is known, its usually due to an infection. In some cases, the organism or pathogen that causes disease can find its way to the heart and directly damage the heart muscle. In other cases, the immune system responds to the infection, resulting in an inflammatory response that can affect the heart muscle. […] Additionally, some autoimmune diseases, like lupus, can cause the immune system to mistakenly turn against the heart, resulting in inflammation and myocardial damage.

• #5 Myocarditis – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/myocarditis-and-pericarditis/myocarditis

  Myocarditis may result from infectious or noninfectious causes. Many cases are idiopathic (see table Causes of Myocarditis). […] Infectious myocarditis is most often viral in the United States and other high income nations. The most common viral causes in the United States are parvovirus B19 and human herpes virus 6. In lower income nations, infectious myocarditis is most often associated with rheumatic carditis, Chagas disease, or HIV infection. Direct myocardial injury due to infection with SARS-CoV-2, with symptoms ranging from mild chest discomfort to fulminant myocarditis, is uncommon in patients with COVID-19, but the risk of myocarditis is 16 times higher in those with infection than in those not infected. […] Noninfectious causes include cardiotoxins, certain medications, and some systemic disorders. Myocarditis caused by medications is termed hypersensitivity myocarditis. Myocarditis after mRNA-based COVID-19 vaccination is rare and far less common than COVID-associated myocarditis. It occurs mostly in adolescent and young adult males, usually within a week of vaccination, and is generally mild.

• #5 Myocarditis – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/myocarditis-and-pericarditis/myocarditis

  Eosinophilic myocarditis has various causes. It is an inflammatory cardiomyopathy characterized by eosinophilic infiltration; among the causes is hypersensitivity myocarditis. […] Giant cell myocarditis is a rare form of myocarditis with a fulminant course. The etiology is unclear but may include an autoimmune mechanism.

• #6 Myocarditis – Wikipedia

  https://en.wikipedia.org/wiki/Myocarditis

  Myocarditis is most often due to a viral infection. Other causes include bacterial infections, certain medications, toxins and autoimmune disorders. […] While many causes of myocarditis are known, there are many cases in which a causative agent cannot be identified. In Europe and North America, viruses are common culprits. Worldwide, however, the most common cause is Chagas disease, an illness endemic to Central and South America that results from infection with the protozoan Trypanosoma cruzi. Overall, myocarditis can be caused by infections, immune conditions, toxins, drug reactions, and physical injuries to the heart. […] The most common causes of myocarditis are infectious organisms. Viral infections are the most common cause in developed countries, with a majority of cases being caused by those with single-stranded RNA genomes, such as Coxsackie viruses (especially Coxsackie B3 and B5). Globally, Chagas disease is the leading cause of myocarditis, which results from infection with the protozoan Trypanosoma cruzi. Bacteria can also result in myocarditis, although it is rare in patients with normal heart function and without a preexisting immunodeficiency.

• #7 Myocarditis: Etiology, Pathogenesis, and Their Implications in Clinical Practice

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10295542/

  In this review, we discuss the possible etiologies of myocarditis, outline the key processes governing its pathogenesis and summarize best available evidence regarding patient outcomes and state-of-the-art therapeutic approaches. […] Viruses are widely considered to be a key factor in the pathogenesis of myocarditis due to the widespread presence of viral genomes in EMB samples collected from patients with myocarditis. […] Studies report presence of viral genomes in the myocardium of almost 70% of patients with idiopathic DCM, and in nearly 30% of such patients, multiple viral agents were present. […] However, available evidence suggests that viruses can also induce myocarditis in the absence of direct cardiotoxicity, doing so instead via virus-mediated inflammatory response during infection (autoimmune myocarditis) with no viral genome present in EMB.

• #8 Azthena logo with the word Azthena

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

  Myocarditis is the term used to describe the acute infective, autoimmune, or toxic inflammation of the heart muscle, which is also known as myocardium. […] The prognosis and treatment of myocarditis depend on the etiology, while clinical and hemodynamic data can provide guidance to decide when the patient needs to be referred to a specialist for endomyocardial biopsy. […] Even though a broad spectrum of etiologies has been implicated as causes of myocarditis, viral myocarditis still represents the prototype for studying this disease and its evolution. […] Enteroviruses (namely Coxsackie group B serotypes) have traditionally been perceived as the predominant viral cause of myocarditis; however, the development of new molecular techniques resulted in the recognition of parvovirus B19 and human herpesvirus 6 as the main viral causes of myocarditis.

• #9 Myocarditis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/myocarditis/

  Myocarditis is most commonly caused by a viral infection (e.g., parvovirus B19, coxsackievirus infection) but can also occur in patients with acute rheumatic fever or autoimmune diseases (e.g., systemic lupus erythematosus, vasculitis). […] Most commonly implicated: enterovirus (e.g., coxsackie B1-B5 virus), parvovirus B19, human herpesvirus 6, adenovirus, HCV, HIV. […] Other viruses: EBV, CMV, echovirus, influenza A H1N1, SARS-CoV-2. […] Acute rheumatic fever due to group A hemolytic streptococcus. […] Toxic substances (e.g., carbon monoxide, black widow venom). […] Medications (e.g., sulfonamides; , immune checkpoint inhibitors), chemotherapy (e.g., anthracycline, doxorubicin). […] Genetic variants associated with myocarditis (e.g., DSP variants). […] Vaccines (e.g., smallpox, SARS-CoV-2). […] Patients with myocarditis typically have no ASCVD risk factors.

• #10 Causes and Management of Myocarditis – RCEMLearning

  https://www.rcemlearning.co.uk/reference/myocarditis/

  Myocarditis is an acute infectious or immunologically mediated syndrome causing inflammation of the heart muscle. Many aetiological agents have been implicated as causes of myocarditis. These include a wide variety of infectious agents, systemic diseases, drugs and environmental toxins. Around half of all cases are idiopathic. Viruses are considered to be the most frequent cause of myocarditis in the developed world. The enteroviruses (Cocksackie A and B) are most commonly encountered and show a seasonal pattern of presentation with peaks in the spring and autumn. It is likely that as advances in the detection of viruses from blood and tissue samples are made, more patients with a viral aetiology will be identified. Most authorities agree that since myocarditis often develops some days or weeks after acute infection, an immunologically mediated reaction occurs rather than direct attack on the cardiac muscle by the causative organism. The commonest cause of myocarditis and subsequent dilated cardiomyopathy worldwide is Chagas disease caused by the protozoan Trypanosoma cruzi. Myocarditis has a significant morbidity and mortality and may present as sudden death in a previous healthy individual. There are many causes of myocarditis and a thorough clinical history and examination are mandatory.

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

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

  Myocarditis is inflammation of the heart muscle (also called myocardium). […] Many people who get myocarditis are otherwise healthy. Several things can lead to it, with infection being the most common cause. […] Infections, especially viral infections, are the biggest cause of myocarditis. […] Some infections that can cause myocarditis include: Viruses, such as Adenovirus, SARS-CoV-2, Coxsackie B viruses, Cytomegalovirus, Echovirus, Epstein-Barr virus, Hepatitis B, Hepatitis C, Herpes, HIV, Influenza, Parvovirus B-19, Rubella, Varicella, and Bacteria, such as Borrelia, Chlamydia, Corynebacterium, Mycoplasma, Streptococcus, Staphylococcus, Treponema. […] Myocarditis can also be caused by an autoimmune disease that causes inflammation throughout your body, such as lupus or rheumatoid arthritis.

• #12 Myocarditis – Heart and Blood Vessel Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/pericardial-disease-and-myocarditis/myocarditis

  Myocarditis may be caused by many disorders, including infection, toxins and medications that affect the heart, and systemic (bodywide) disorders such as sarcoidosis, but often the cause is unknown. […] Myocarditis may result from infectious or noninfectious causes. Many cases are unable to be identified (idiopathic). […] In the United States and most other developed nations, infectious myocarditis is most often caused by a viral infection. […] The most common viral causes in the United States are parvovirus B19 and human herpesvirus 6. […] SARS-CoV-2, the virus that causes COVID-19, sometimes causes myocarditis. […] Noninfectious causes include substances that are toxic to the heart (such as alcohol and cocaine), certain medications, and some autoimmune and inflammatory disorders. […] Myocarditis may also occur after mRNA-based COVID-19 vaccination and is rare. […] Myocarditis caused by medications is termed hypersensitivity myocarditis.

• #13 Myocarditis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/myocarditis/symptoms-causes/syc-20352539

  Myocarditis is inflammation of the heart muscle. This illustration shows typical heart muscle compared with damaged heart muscle due to inflammation. […] Infection with a virus is one cause of myocarditis. Sometimes myocarditis is caused by a medicine reaction or a condition that causes inflammation throughout the body. […] Infections can cause myocarditis. […] Many viruses have been linked to myocarditis, including the adenovirus, which causes the common cold; the COVID-19 virus; viruses that cause hepatitis B and C; parvovirus, which causes a mild rash, usually in children; and herpes simplex virus. […] Myocarditis also may be caused by: Certain medicines or illegal drugs. These include medicines used to treat cancer; antibiotics, such as penicillin and sulfonamide drugs; some anti-seizure medicines; and cocaine. When these cause myocarditis, it’s called drug-induced myocarditis. […] Other health conditions. Conditions that may cause myocarditis include lupus, Wegener’s granulomatosis, giant cell arteritis and Takayasu’s arteritis. […] Often, the cause of myocarditis isn’t found.

• #14 Azthena logo with the word Azthena

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

  Hepatitis C virus has also been associated with myocarditis, as HCV antibodies and RNA have been found in the sera and cardiac tissue of patients with biopsy-proven myocarditis. […] Myocarditis can also be triggered by different non-viral infections, which should certainly be considered in patients with acute or chronic cardiomyopathy. […] The condition can often arise from the infection with Borrelia burgdorferi, which is a cause of Lyme disease. […] Drug-induced hypersensitivity and systemic hypereosinophilic syndromes may result in specific myocarditis. […] Some of the different drugs that are implicated in this condition include antibiotics, namely penicillins, cephalosporins, and sulfonamides, anticonvulsants, antipsychotics, and antidepressants. […] Cardiac sarcoidosis and giant cell myocarditis, which are two idiopathic and histologically similar disorders, represent rare causes of inflammatory myocardial disease. […] Autoimmune diseases that are associated with myocarditis include Whipples disease, celiac disease, systemic lupus erythematosus, mixed connective tissue disease, systemic sclerosis, and certain hematological abnormalities such as thrombocytopenic purpura.

• #15 Myocarditis – UF Health

  https://ufhealth.org/conditions-and-treatments/myocarditis

  Myocarditis is an uncommon disorder. Most of the time, it is caused by an infection that reaches the heart. […] Many cases are caused by a virus that reaches the heart. These can include the SARS-CoV-2 virus (the virus that causes COVID-19), influenza (flu) virus, coxsackievirus, parvovirus, cytomegalovirus, adenovirus, and others. […] It may also be caused by bacterial infections such as Lyme disease, streptococcus, mycoplasma, and chlamydia. […] Other causes of myocarditis include: Reactions to certain medicines, such as certain chemotherapy medicines; Exposure to chemicals in the environment, such as heavy metals; Infections due to fungus or parasites; Radiation; Autoimmune disorders that cause inflammation throughout the body; Myocarditis following COVID-19 vaccination has been reported, but is very rare. […] Sometimes the exact cause may not be discovered.

• #16 Myocarditis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000149.htm

  Myocarditis is an uncommon disorder. Most of the time, it is caused by an infection that reaches the heart. […] Many cases are caused by a virus that reaches the heart. These can include the SARS-CoV-2 virus (the virus that causes COVID-19), influenza (flu) virus, coxsackievirus, parvovirus, cytomegalovirus, adenovirus, and others. […] It may also be caused by bacterial infections such as Lyme disease, streptococcus, mycoplasma, and chlamydia. […] Other causes of myocarditis include: Reactions to certain medicines, such as certain chemotherapy medicines, Exposure to chemicals in the environment, such as heavy metals, Infections due to fungus or parasites, Radiation, Autoimmune disorders that cause inflammation throughout the body, Myocarditis following COVID-19 vaccination has been reported, but is very rare. […] Sometimes the exact cause may not be discovered.

• #17 Myocarditis: Causes, symptoms, treatment, outlook, and more

  https://www.medicalnewstoday.com/articles/myocarditis

  Myocarditis describes inflammation of heart tissue known as the myocardium. This inflammation can affect the electrical system of the heart and reduce the hearts ability to pump blood around the body. […] According to the National Organization for Rare Disorders, most cases of myocarditis have no known cause. […] However, some possible causes of myocarditis include: […] When doctors can find a cause for myocarditis, the cause is usually a viral infection. […] Viral infections that can cause myocarditis include: adenovirus, coxsackievirus, Epstein-Barr virus, HIV, chickenpox, human herpesvirus 6. […] Several types of bacterial infection can cause myocarditis. […] Sometimes, myocarditis manifests as a complication of endocarditis. […] The bacterium Corynebacterium diphtheriae, which causes diphtheria, can also cause myocarditis.

• #18 Update on Myocarditis: From Etiology and Clinical Picture to Modern Diagnostics and Methods of Treatment

  https://www.mdpi.com/2075-4418/13/19/3073

  Myocarditis is a disease of the heart muscle caused by inflammation, which is the most often the result of an infectious process, although it can also be caused by hypersensitivity to drugs, radiation, metabolic disorders, collagenoses, sarcoidosis, Kawasaki disease, and exposure to excessive heat or chemicals. […] The previously known most common viral etiology of this disease is today overshadowed by new findings based on immune-mediated processes, associated with diseases that in their natural course can lead to myocardial involvement, as well as the iatrogenic cause of myocarditis, which is due to use of immune checkpoint inhibitors in the treatment of cancer patients. […] Cardiotropic viruses are the most common causes of myocarditis, and lead to cardiomyocyte damage through direct cardiotoxic effects.

• #19 Understanding Myocarditis – Myocarditis Foundation

  https://www.myocarditisfoundation.org/about-myocarditis/

  Myocarditis is classified as a rare disease but is estimated to affect thousands of adults and children in the U.S. and around the world each year. […] Viral infections are a leading cause of myocarditis. Inflammation occurs during the course of infection, putting stress on the heart that remains even after the infection is resolved. Cancer, bacterial infections and other contagious diseases can also cause myocarditis, as can exposure to environmental toxins ranging from metal poisons to spider and snake venom. […] A significantly smaller group of individuals with autoimmune conditions may develop giant cell myocarditis. […] Currently there are no known lifestyle choices or medical treatments that can prevent myocarditis. […] No lifestyle changes or medical treatments are known to prevent viral myocarditis. […] Because myocarditis is rare, information is limited regarding its causes and effective treatments. Myocarditis is not believed to be inherited. No genes are known to predispose people to myocarditis.

• #20 Myocarditis: Background, Etiology, Pathophysiology

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

  Myocarditis is probably caused by a wide variety of infectious organisms, including in pediatric patients, autoimmune disorders, and exogenous agents, with genetic and environmental predisposition. […] Most cases are presumed to be caused by a common pathway of host-mediated, autoimmune-mediated injury, although direct cytotoxic effects of the causative agent and damages due to cytokine expression in the myocardium may play some role in myocarditis etiology. Damage occurs through the following mechanisms: […] In myocarditis related to coronavirus disease 2019 (COVID-19), cardiac inflammation is generally due to direct cardiac invasion with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or a result of the intense cytokine storm that often arises during the course of the disease.

• #21 Myocarditis: Symptoms and Treatment for Inflammation of the Heart

  https://www.healthline.com/health/heart-disease/myocarditis

  The way that COVID-19 causes myocarditis is unknown, although doctors and scientists do have some theories, which include one or a combination of the following: the virus could be directly infecting the heart muscle, which contains receptors for the virus; the activity of the immune system as it tries to respond to COVID-19 could be leading to myocarditis; hypoxia, a reduction in the oxygen levels in your bodys organs and tissues, could be contributing to myocarditis. […] Myocarditis is also a rare side effect of the COVID-19 vaccine. According to the CDC, this side effect is more common in male patients, particularly those who are adolescents or young adults, following vaccination with an mRNA vaccine, which includes the Pfizer-BioNTech and Moderna vaccines, after receiving the second dose of an mRNA vaccine, within a week of getting vaccinated. […] The treatment of myocarditis depends on the source and severity of the myocardial inflammation. In many cases, myocarditis improves with proper measures, and youll recover completely.

• #22 Myocarditis: Etiology, Pathogenesis, and Their Implications in Clinical Practice

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10295542/

  Despite the fact viruses are the most studied etiological agents in myocarditis, clear evidence on the exact pathological mechanisms is lacking. […] The exact mechanisms behind myocardial injury induced by other viruses are not well understood. […] The presence of herpesviruses is not uncommon in patients with myocarditis or DCM. […] The pathogenesis of Chagas disease has been extensively studied in animal models and clinical observation. […] Myocarditis can be caused by a wide range of protozoa and helminths, with Trypanosoma spp. appearing as the most relevant etiological agents. […] Autoimmune myocarditis is diagnosed in the presence of immunohistological evidence of myocarditis with negative viral PCR, with or without serum anti-heart antibodies. […] These patients present yet another heterogenous group, because autoimmune myocarditis can occur with exclusive cardiac involvement as well as in the course of an immune-mediated disease such as sarcoidosis, systemic sclerosis (SSc), systemic lupus erythematosus (SLE) or eosinophilic granulomatosis with polyangiitis (EGPA).

• #22 Myocarditis: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/myocarditis-pro

  Myocarditis is acute or chronic inflammation of the myocardium – and may present similarly to myocardial infarction. […] What causes myocarditis? (Aetiology) […] Viral infection is the most common cause of acute myocarditis. […] Coxsackievirus is the most common viral cause in Europe and the USA; however, most viruses are potential agents, including adenovirus, parvovirus B19, enteroviruses, HIV, Epstein-Barr virus and hepatitis A and hepatitis C. […] Worldwide the most common bacterial cause is diphtheria. […] There are also spirochetal, fungal, parasitic and rickettsial causes. […] The protozoal Chagas’ disease is a common entity worldwide. […] Eosinophilic myocarditis is a rare form of myocardial inflammation with variable aetiology. In developed countries, the most common causes are hypersensitivity or allergic reactions, as well as various conditions leading to eosinophilia.

• #23 Myocarditis – Harvard Health

  https://www.health.harvard.edu/a_to_z/myocarditis-a-to-z

  Myocarditis is an inflammation of the heart muscle that decreases the ability of the heart to pump blood normally. It can be caused by: […] Many infections have been associated with myocarditis. Some of the more likely germs include: […] A common cause of myocarditis. Many different viruses can cause myocarditis. Examples include adenovirus, coxsackievirus, Epstein-Barr virus, HIV, varicella (chickenpox), human herpes virus 6 and SARS CoV-2 (COVID-19). […] Rarely, myocarditis is a complication of endocarditis, an infection of the heart valves and the lining inside the heart’s chambers caused by bacteria. […] This infection, caused by the protozoan Trypanosoma cruzi, is transmitted by an insect bite. […] Lyme disease, an infection caused by the tick-borne bacterium Borrelia burgdorferi, can cause myocarditis or other heart problems.

• #24 Myocarditis | Causes, Symptoms, & Treatment | Britannica

  https://www.britannica.com/science/myocarditis

  myocarditis, inflammation of the heart muscle, or myocardium. Myocarditis is caused by a variety of infectious agents but also may result from systemic disease or may occur as a manifestation of a generalized hypersensitivity (allergic or immunologic) reaction throughout the body. […] The most common cause is acute rheumatic fever. […] Treatment and prospects of recovery depend on the underlying cause.

• #25 Infectious factors in myocarditis: a comprehensive review of common and rare pathogens | The Egyptian Heart Journal | Full Text

  https://tehj.springeropen.com/articles/10.1186/s43044-024-00493-3

  The pathogenesis of viral myocarditis includes direct injury by viral infection and consequent damage secondary to the hosts immune response. […] The interaction between CVB3 and miRNAs also plays a critical role in viral pathogenesis. […] The evidence suggests that SARS-CoV-2 may directly infect and impair myocardial tissue, which in turn induces myocarditis. […] In individuals with immunocompetent populations, it is usually asymptomatic, but reactivation can occur frequently. […] Myocarditis caused by Trypanosoma cruzi is marked by focal inflammation, cardiomyocyte lysis, necrosis, and progressive fibrosis of the heart. […] Myocarditis caused by Toxoplasma gondii is more usual in patients with AIDS. […] Myocarditis is a rare but important consequence of Campylobacter jejuni, whose common symptom is chest pain secondary to diarrhea.

• #26 Infectious factors in myocarditis: a comprehensive review of common and rare pathogens | The Egyptian Heart Journal | Full Text

  https://tehj.springeropen.com/articles/10.1186/s43044-024-00493-3

  Myocarditis caused by Clostridium difficile is pathologically characterized by inflammation dominated by a neutrophilic infiltrate. […] Myocarditis is an infrequent complexity of Neisseria meningitidis infection. […] Myocarditis can occur as a rare presentation of brucellosis. […] Myocarditis due to Candida remains extremely scarce, with only a few cases having been described. […] Fungal myocarditis arises in disseminated fungal infections, which are often only detected post-mortem.

• #27 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. […] There are many causes of myocarditis, including: Infection, Medications, Chemicals, Radiation, Certain diseases that cause inflammation in many different organs of the body. […] In most children, myocarditis is triggered by an infection, usually viral, involving the heart. […] In children, viral infections are the most common causes for myocarditis. The most common viruses involved are: Parvovirus, Influenza virus, Adenovirus and coxsackie virus, Viruses such as rubella, rubeola and HIV. […] Rarely, bacteria such as those causing Lyme disease, Rocky Mountain spotted fever, or toxic shock syndrome, or fungus or parasites can cause myocarditis. […] Most of the damage to the heart is caused by the body’s immune reaction to the germ, and not by the germ itself.

• #28 Myocarditis: Symptoms and Treatment for Inflammation of the Heart

  https://www.healthline.com/health/heart-disease/myocarditis

  If myocarditis is caused by a fungal infection, its typically caused by Candida or Aspergillus species. […] Parasites are microorganisms that live off other organisms to survive. They can also cause myocarditis. This is rare in the United States. Its more commonly seen in Central and South America, where the parasite Trypanosoma cruzi causes a condition known as Chagas disease. […] Autoimmune diseases that cause inflammation in other parts of the body can also cause myocarditis. Some examples include lupus and rheumatoid arthritis. […] In very rare cases, myocarditis may be caused by a condition known as giant cell myocarditis (GCM) that involves the growth of abnormally large cells that cause inflammation and damage to the heart muscle. […] While COVID-19 is often associated with respiratory illness, we now know that it can impact many other parts of the body. This includes the heart, where it can cause myocarditis.

• #29 Myocarditis: Etiology, Pathogenesis, and Their Implications in Clinical Practice

  https://www.mdpi.com/2079-7737/12/6/874

  The understanding of myocarditis has greatly improved in recent years, but many questions still remain to be answered. As it stands, it is unclear why some patients progress to DCM, while others spontaneously recover. The therapeutic significance and prognostic utility of etiopathogenesis, patients’ genetic background and mechanisms participating in the immune response are still not entirely understood. […] Myocarditis can be caused by a wide range of protozoa and helminths, with Trypanosoma spp. appearing as the most relevant etiological agents. […] Autoimmune myocarditis is diagnosed in the presence of immunohistological evidence of myocarditis with negative viral PCR, with or without serum anti-heart antibodies. These patients present yet another heterogenous group, because autoimmune myocarditis can occur with exclusive cardiac involvement as well as in the course of an immune-mediated disease such as sarcoidosis, systemic sclerosis (SSc), systemic lupus erythematosus (SLE) or eosinophilic granulomatosis with polyangiitis (EGPA). It can also be induced by exposure to various substances (e.g., drugs, alcohol, vaccines).

• #30 Myocarditis Types, Symptoms and Prevention

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

  Trypanosoma cruzi, Toxoplasma, and parasites transmitted by insects may cause myocarditis. […] Sometimes, a fungal infection may cause myocarditis. It is more common among people with weak immune systems. Yeast infections (candida), molds (aspergillus), and bird droppings may cause this condition. […] Certain medications and illegal drugs may cause myocarditis. Medicines that treat cancer, anti-seizure medications, and antibiotics are also responsible for causing myocarditis. […] Inflammation of heart muscle may be caused due to exposure to carbon monoxide and radiation. […] Some conditions, such as Takayasu’s arteritis, lupus, giant cell arteritis, and Wegener’s granulomatosis, may cause myocarditis.

• #31 Myocarditis: Causes, symptoms, treatment, outlook, and more

  https://www.medicalnewstoday.com/articles/myocarditis

  Myocarditis can also happen due to Lyme disease. […] Chagas disease can cause myocarditis by infecting the heart muscle. […] According to the National Center for Advancing Translational Diseases, autoimmune conditions occur when the bodys immune system begins to attack healthy tissue. […] Some autoimmune conditions that could give rise to myocarditis include: lupus, rheumatoid arthritis. […] According to the Lupus Foundation of America, lupus can cause the myocardium to become inflamed. […] In rare cases, rheumatoid arthritis can also cause myocarditis. […] Several environmental factors may cause myocarditis. […] According to one 2020 article, exposure to some heavy metals can cause myocarditis. […] In rare cases, myocarditis may occur following a spider or snake bite.

• #32 Viruses are the most common cause of myocarditis in children, experts offer guidance | American Heart Association

  https://newsroom.heart.org/news/viruses-are-the-most-common-cause-of-myocarditis-in-children-experts-offer-guidance

  Viral infection is the most common cause of inflammation in the heart muscle, called myocarditis, in children; however, there remains a diverse array of infectious and non-infectious causes of myocarditis that should be considered in diagnosis. […] In children, myocarditis is most often the result of a viral infection, and it is most often acute or sudden-onset, rather than chronic myocarditis, which is seen more often in adults. […] Myocarditis can also be seen secondary to systemic autoimmune diseases and is associated with rheumatic fever or Kawasaki disease. In these cases, it should be managed according to the guidance for the primary disease. […] A new condition has emerged during the COVID-19 pandemic multisystem inflammatory syndrome in children (MIS-C) that involves the myocardium and coronary arteries in some infected patients. Therapy may consist of antiviral, IVIG (intravenous immunoglobulin), steroid and other anti-inflammatory medications used in atypical Kawasaki disease. […] The effects of COVID-19 infection include its potentially fatal consequences and the potential long-term health effects that are still revealing themselves, such as conditions affecting the heart including myocarditis, the brain, the vascular system and other organs.

• #33 What Is Myocarditis ?

  https://www.icliniq.com/articles/heart-circulatory-health/myocarditis

  Coxsackie B virus. […] EBV or Epstein-Barr virus. […] Cytomegalovirus (CMV). […] Herpes simplex virus. […] Human immunodeficiency virus. […] Hepatitis C. […] Parvovirus. […] Chlamydia. […] Streptococcal bacterial infection. […] Mycoplasma infection. […] Treponema infection. […] Borrelia infection. […] Toxins such as alcohol and drugs- cocaine. […] Lead toxin. […] Toxins released after spider bites. […] Wasp stings. […] Toxins after a snakebite. […] Chemotherapy. […] Radiation therapy. […] Allergies to certain medications and antibiotics. […] Graves disease (an autoimmune disorder that causes overactivity of the thyroid gland, leading to symptoms such as hyperthyroidism and an enlarged thyroid). […] Postpartum cardiomyopathy (a rare form of heart failure that occurs in women during late pregnancy or in the months following childbirth).

• #34 Myocarditis Center | UCSF Cardiology

  https://ucsfhealthcardiology.ucsf.edu/patient-care/clinical-services/myocarditis-center

  Exposure to certain drugs can lead to myocarditis through either direct cardiotoxic effects or exaggerated immune responses (hypersensitivity). Examples of drugs associated with myocarditis include clozapine, immune checkpoint inhibitors, and cocaine. […] Rarely, vaccinations such as the COVID-19 vaccine and smallpox vaccine have been associated with myocarditis. Although the precise mechanism is unclear, it is thought that vaccines may trigger an immune reaction leading to myocarditis. […] Immune Checkpoint Inhibitors (ICI): In the last decade, immunotherapies have transformed cancer care. Immune Checkpoint Inhibitors (ICI) unleash the immune cells to fight cancer and have been instrumental in the treatment of previously deadly cancers. […] Recent research has shown that certain gene mutations associated with cardiomyopathy are associated with myocarditis. […] It is clear from patient population studies that there are sex differences between the prevalence and severity of myocarditis. Assessing how our hormones (estrogens and testosterone) affect heart inflammation has been a new topic of research.

• #35 Myocarditis: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/myocarditis-pro

  Drugs causing hypersensitivity reactions: Clozapine, acetazolamide, amitriptyline, cefaclor, colchicine, furosemide, isoniazid, lidocaine, methyldopa, penicillin, phenytoin, streptomycin, tetracycline, thiazides and tetanus toxoid. […] Toxic myocarditis: Drugs: ethanol, cytotoxic antibiotics (anthracyclines – eg, doxorubicin), amfetamines, cocaine, cyclophosphamide, fluorouracil, lithium, interleukin-2 and trastuzumab may exert a direct cytotoxic effect. […] Heavy metal poisoning: lead, copper, iron. […] Others: arsenic, insect stings and bites, phosphorus, carbon monoxide and inhalants.

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

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

  Other causes include certain chemicals or allergic reactions to toxins such as Alcohol, Drugs such as cocaine, Lead and other heavy metals, Spider bites, Wasp stings, Snakebites, Carbon monoxide, Radiation. […] Some medications can cause myocarditis, including Chemotherapy and radiation therapy, Medications for your heart, Antidepressants and other psychiatric drugs, Medications for seizures, such as benzodiazepines, Antibiotics, Medications for weight loss, Diuretics, Vaccines, including the COVID-19 vaccine. […] It is very rare for the COVID-19 vaccine to cause myocarditis. Only 2 out of every 100,000 people who get the vaccine get myocarditis. […] Young men and people assigned male at birth (aged 16-29) are more likely to get myocarditis as a side effect of the COVID-19 vaccine. […] Myocarditis and cardiomyopathy are the leading causes of heart transplants in the U.S. […] In very rare cases, myocarditis can lead to sudden death.

• #37 Causes Of Myocarditis, and How to Reduce Your Risk | Lompoc Valley Medical Center

  https://www.lompocvmc.com/blogs/2023/february/causes-of-myocarditis-and-how-to-reduce-your-ris/

  Myocarditis is a heart condition that affects an estimated 1.5 million people a year or 10 to 20 per 100,000 people. […] The most common causes of myocarditis are viruses, bacterial infections, parasites, and fungal infections. These types of illnesses can cause body-wide inflammation that also affects the heart. Non-infectious autoimmune disorders, such as lupus, may also cause myocarditis. […] The American Heart Association reports that several recent studies show that the COVID-19 virus and vaccines may cause myocarditis. It says that people may develop this heart condition after receiving the first or second vaccine dosage and that an estimated three in every 1,000 patients hospitalized due to a COVID-19 infection may be at risk for developing acute myocarditis. […] Many types of medications have been linked to myocarditis including medications used to treat depression, anxiety, and cancer. Studies have also linked vaccines to this heart condition, including the COVID-19 vaccines. […] Insecticides, pesticides, carbon monoxide, and radiation therapy are some of the many toxins and chemicals that may increase your risk for heart inflammation and myocarditis.

• #38 Myocarditis: Symptoms and Treatment for Inflammation of the Heart

  https://www.healthline.com/health/heart-disease/myocarditis

  Viruses are the most common cause of myocarditis. Some examples of viruses that are known to cause myocarditis include: coxsackievirus group B, a type of enterovirus; parvovirus B19, which is the cause of fifth disease; adenovirus, a type of virus that causes the common cold; SARS-CoV-2, the coronavirus that causes COVID-19. […] Myocarditis can also result from a bacterial infection. A few examples of bacteria that can cause myocarditis are: Staphylococcus aureus, the bacterium that can cause impetigo and potentially methicillin resistant infections (MRSA); Corynebacterium diphtheriae, the bacterium that causes diphtheria, an acute infection that destroys tonsil and throat cells; Borrelia burgdorferi, the bacterium that causes Lyme disease. […] Fungi are rarer causes of myocarditis. In general, serious fungal infections are more common in people who have a weakened immune system.

• #39 Myocarditis | Heart Condition – Heart Foundation NZ

  https://www.heartfoundation.org.nz/your-heart/heart-conditions/myocarditis

  Myocarditis is inflammation of the heart muscle. […] A viral infection is the most common cause of myocarditis. This can include viruses such as the common cold (adenovirus), Hepatitis B and C, and COVID-19. […] Bacterial and fungal infections can also cause it. […] You can develop myocarditis if you have an autoimmune disease, for example, type 1 diabetes or rheumatoid arthritis. This is because the autoimmune disease can cause inflammation in other body areas. […] Some medicines and illegal drug use can also cause myocarditis. […] Myocarditis is a rare side effect of some COVID-19 vaccinations (including the Pfizer vaccination, also called Comirnaty). However, you’re at greater risk of developing myocarditis due to catching the COVID-19 virus than you are from having the vaccine. The benefits of having the vaccine to protect against COVID-19 greatly outweigh the risks. […] The risk of myocarditis is much greater from COVID-19 complications than vaccination.

• #40 Myocarditis: Causes, Symptoms, Treatment, Recovery

  https://www.medicinenet.com/myocarditis/article.htm

  Myocarditis is due to inflammation of the muscle cells in the heart. […] Most often myocarditis is caused by a virus infection, usually following an upper respiratory infection like a cold. […] Viral infections are the most common cause of myocarditis in North America and Europe. However, the most common cause of myocarditis worldwide is Chagas disease, an infection caused by the parasite Trypanosoma cruzi. […] Other causes of myocarditis include the following: Idiopathic myocarditis describes the situation where the reason for the inflammation cannot be found. This occurs in almost half the cases and most often in infants and children. […] Autoimmune and immune disorders […] Toxins […] Vaccinations […] Myocarditis was a known rare complication of smallpox vaccination (less than 6 per 10,000 people vaccinated). […] Myocarditis may be rarely associated with SARS COVID-19 vaccination. Young males are more likely at risk, but that risk is less than 1 in 10,000.

• #41 Myocarditis: Etiology, Pathogenesis, and Their Implications in Clinical Practice

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10295542/

  The 2020 AHA Expert Consensus Document defines drug-induced myocarditis as caused by direct cytotoxic effect of the drug. […] Hypersensitivity reactions to drugs and drug reaction with eosinophilia and systemic symptoms (DRESS) are a possible cause of eosinophilic myocarditis. […] The mechanisms responsible for myocarditis following mRNA vaccination against COVID-19 are unknown, but current hypotheses imply maladaptive immune response possibly modified by immune-genetic background, age, sex and hormonal differences.

• #42 Myocarditis | Diagnosis & Disease Information – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/myocarditis/

  Medical conditions that can increase myocarditis risk include diabetes mellitus, eating disorders, and chest injury. […] Based on data collected before the COVID-19 pandemic, individuals age 20 to 40 years are at the highest risk of myocarditis. […] The prognosis for myocarditis depends on its etiology and individual patient characteristics.

• #43 Pulsenotes | Myocarditis

  https://app.pulsenotes.com/medicine/cardiology/notes/myocarditis

  Myocarditis can be difficult both to understand theoretically and to diagnose clinically. This is due to myocarditis having: […] In general, myocarditis is usually idiopathic or caused by a viral infection, although there are multiple other causes. […] In 50% of patients, the cause of myocarditis is never found. […] In the UK, when a cause for myocarditis is identified, it is usually a viral infection of the myocardium. Coxsackie virus is the most common viral culprit, although many other viruses can cause myocarditis including adenovirus, parvovirus B19, EBV, and HIV. […] Other causes of myocarditis are shown in the table below: […] The pathophysiology of myocarditis is divided into three main stages: Direct myocardial damage, Immune response to damage, Resolution OR chronic disease.

• #44 Viral myocarditis—diagnosis, treatment options, and current controversies | Nature Reviews Cardiology

  https://www.nature.com/articles/nrcardio.2015.108

  The organisms reported to cause infective myocarditis and pericarditis in England and Wales. […] Clinical and prognostic significance of detection of enteroviral RNA in the myocardium of patients with myocarditis or dilated cardiomyopathy. […] Viral persistence in the myocardium is associated with progressive cardiac dysfunction. […] A prospective study of biopsy-proven myocarditis: prognostic relevance of clinical and aetiopathogenetic features at diagnosis. […] Viral infection and the pathogenesis of dilated cardiomyopathy.

• #45 Viral myocarditis—diagnosis, treatment options, and current controversies | Nature Reviews Cardiology

  https://www.nature.com/articles/nrcardio.2015.108

  Myocarditis is a frequent cause of dilated cardiomyopathy with heterogeneous clinical presentations and a wide range of clinical outcomes. […] After infection by a cardiotropic virus, a maladaptive post-viral response ensues, which can cause myocardial cell dysfunction and compromised contractility. […] Characterization of this disease has been hampered by its heterogeneous clinical presentations and diverse aetiologies. […] Advances in cardiac MRI and molecular detection of viruses by endomyocardial biopsy have improved our ability to diagnose and understand the pathophysiological mechanisms of this elusive disease. […] Several randomized, controlled trials have demonstrated potential benefit with immunosuppressive and immunomodulatory therapies, but further investigations are warranted.

• #46 Viral myocarditis

  https://smw.ch/index.php/smw/article/download/1906/2694?inline=1

  The term myocarditis describes inflammatory disorders of the heart muscle of varied infectious and non-infectious origins. It can be caused by any kind of infection, drugs, toxic substances, or be associated with autoimmune conditions. Viruses are the main causes at least in developed countries. […] Infectious agents are the major causes of myocarditis and inflammatory cardiomyopathy (DCMI) in acquired idiopathic diseases of the heart muscle. Although virtually any microbial agent can cause myocardial inflammation and dysfunction, non-viral infections are rare in these conditions, at least in western countries. Viral forms are considered the most common cause of acquired inflammatory cardiomyopathies nowadays. […] For decades coxsackieviruses and, to a lesser extent adenoviruses, are well established in paediatric and adult myocarditis and chronic heart muscle disease. Furthermore, distinct genotypes of erythroviruses including parvovirus B19 (B19V), human herpesvirus type 6 (HHV6A/B and ciHHV6), human immune deficiency virus (HIV), cytomegalovirus (CMV), herpes simplex type 2 virus and hepatitis C virus, among many others have been identified with varying degrees of frequency in cardiac tissues.

• #47 Myocarditis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/myocarditis-in-children

  Another factor that varies from person to person is the body’s response to an infection (immune response). Sometimes the immune response is too strong. When this happens, the body fights the virus too hard and ends up hurting its own cells. When this happens in the heart, the muscle may be permanently damaged.

• #48 Myocarditis: Causes, Symptoms, and Treatment

  https://patient.info/heart-health/myocarditis-leaflet

  A rare side-effect of some medicines and a rare complication of various diseases. […] Other damaging agents. For example, inflammation in the heart can be caused by excess alcohol, radiation, certain chemicals and certain poisons. […] In most cases of viral myocarditis, the illness goes away on its own and there are no complications. […] Complications are more likely with the more uncommon causes of myocarditis. Sometimes the inflammation clears but the heart is left with some permanent damage. […] In some cases, the inflammation and heart damage are so severe that the only treatment option is a heart transplant. […] Myocarditis is fatal in some cases. In some cases death occurs some time after the diagnosis is made if the condition becomes worse and unresponsive to treatment. Also, some cases of sudden death in a previously healthy person are due to an acute myocarditis that develops rapidly.

• #49 Viral myocarditis

  https://smw.ch/index.php/smw/article/download/1906/2694?inline=1

  The overall incidence of myocardial involvement in any viral infections is estimated at 36%. The actual incidence of virus induced myocarditis or cardiomyopathy is less well established. The majority of viral infections is asymptomatic or oligosymptomatic and due to the infrequent use of biopsy based diagnoses, such infections are frequently not recognised as possible causes of acute or delayed onset heart failure. […] Chronic myocardial injury in viral myocarditis develops if the antiviral immune response fails to eliminate the infectious agent completely or, if the inflammatory process does not resolve properly despite virus clearance. In such conditions, long-term outcome depends on the nature and extent of the virus-affected tissue compartments which varies considerably with the amount and kind of the infectious agent or the number and subtype of the smoldering cellular inflammatory infiltrates.

• #50 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. […] Many times, the cause of myocarditis is unknown. Most often, the cause is a viral infection. These include: […] Other causes of myocarditis include: […] Side effects from some medicines can bring about myocarditis. […] In rare cases, myocarditis has happened in young people who received the Pfizer-BioNTech or Moderna vaccines for COVID-19. […] Some of the things that put you at risk for myocarditis cant be changed. […] Some medical treatments increase your risk of myocarditis. […] Having one of these medical problems can put you at a higher risk of getting myocarditis: […] Myocarditis is a rare condition that can weaken your heart muscle. Unfortunately, there are many causes of myocarditis that are hard to avoid.

• #51 Myocarditis Causes, Symptoms, and Treatments

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

  Myocarditis is an inflammation of the heart muscle (the myocardium), often caused by a virus or autoimmune disease. […] Viral infections are the leading cause of myocarditis, such as: […] Other causes of myocarditis are: […] 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 genes may play a part in how your body responds to infection or inflammation of the heart. […] Drinking too much alcohol or taking illegal drugs may cause heart inflammation. […] Many causes of myocarditis (such as viruses) are hard to avoid or prevent.

• #52 Myocarditis and inflammatory cardiomyopathy: current evidence and future directions | Nature Reviews Cardiology

  https://www.nature.com/articles/s41569-020-00435-x

  Inflammatory cardiomyopathy, characterized by inflammatory cell infiltration into the myocardium and a high risk of deteriorating cardiac function, has a heterogeneous aetiology. Inflammatory cardiomyopathy is predominantly mediated by viral infection, but can also be induced by bacterial, protozoal or fungal infections as well as a wide variety of toxic substances and drugs and systemic immune-mediated diseases. […] The relative roles of the pathogen, host genomics and environmental factors in disease progression and healing are still under discussion, including which viruses are active inducers and which are only bystanders. […] The role of specific viruses, immune cells and autoimmunity in the pathogenesis of myocarditis and inflammatory cardiomyopathy is still incompletely understood, and advanced animal and cell models are required for future research.

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