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Internal Medicine

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When to suspect myocarditis?

1-Myocarditis should be suspected in patients with or without cardiac signs and symptoms, who have a rise in cardiac biomarkers (eg, troponin), ECG changes suggestive of acute myocardial injury, arrhythmia, or global or regional abnormalities of LV systolic function, particularly if the clinical findings are new and unexplained

2- Clinical suspicion for myocarditis should be high in a patient who presents with clinical signs and symptoms of an acute Mi, particularly if the patient lacks cardiovascular risk factors or the coronary angiogram is normal .

In this setting myocarditis should be distinguished from stress (takotsubo) cardiomyopathy.

3-Pericarditis (infectious or idiopathic) with accompanying cardiac biomarker elevation is suggestive of myopericarditis

Mazen Kherallah
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