Myocarditis : an overview for the primary care clinician

Myocarditis, an inflammatory condition affecting the myocardium, represents a critical area of focus in both acute and chronic cardiac care. Though less frequent than other cardiac conditions such as ischemic heart disease or congestive heart failure, myocarditis poses significant diagnostic and therapeutic challenges, often revealing itself through a myriad of clinical presentations. As a primary care clinician, your first encounter with myocarditis may come in the form of vague and non-specific symptoms, and it is essential to have a clear understanding of this condition to facilitate early diagnosis and appropriate referral.

Myocarditis can occur at any age and affects both genders. While the etiological factors can vary widely, ranging from viral infections to toxins, its presentation can be just as heterogeneous—encompassing asymptomatic states, arrhythmias, cardiogenic shock, and even sudden cardiac death. Given this spectrum of manifestations, a high index of suspicion and appropriate investigations, including electrocardiography and echocardiography, are fundamental to the diagnostic process.

Management mainly consists of supportive care aimed at preserving left ventricular function and treating complications like congestive heart failure and arrhythmias. Severe cases may require more advanced interventions such as ventricular assist devices or cardiac transplantation. Importantly, monitoring and follow-up are critical components of care, often...