A quiz on myocarditis

  1. Most common manifestation of Lyme myocarditis is ?
  2. A 38 year old male presented with orthopnea, fever, fatigue and chronic diarrhea. Echocardiography showed mitral stenosis and aortic valve regurgitation. His work up for chronic diarrhea revealed rod-shaped organisms in intestine biopsy under electron microscopy. What is the most probable diagnosis?
  3. A 26-year-old man presented with heart failure and recurrent constipation. ECG showed BBB and echocardiography revealed apical thinning with clot.
Connect these images

4.A 60 year old male presented with deep vein thrombosis and pleural effusion. He remembers having pepperoni pizza 2 weeks back from a restaurant. Investigations show peripheral eosinophilia and frequent VPC in ECG. Echo showed LV global hypokinesia and dilated LV. He underwent an endomyocardial biopsy for futher evaluation. What finding u expect in his EMB?

5.Clozapine myocarditis-Peak incidence occurs after how many weeks of initiation of drug?

6.Fulminant myocarditis may be caused by combination immune check point blockade by?

7.Cardiac infection of B19 V can be demonstrated in myocardial cells.True or false?

8.An early consideration for ICD should be taken  in which all myocarditis?

9.Multifocal inflammatory infiltrate of lymphocyte and multinucleated giant cells without granuloma is seen in EMB in ?

10.A 20 year old female presented with AV block. Echo showed basal septal thinning and metabolism-perfusion mismatch in Ru-FDG PET. Diagnosis ?

2 thoughts on “A quiz on myocarditis

  1. ANSWERS

    1.AV block
    Demonstration of spirchetes in myocardial biopsy or abnormal gallium scan established the diagnosis.
    Treatment of AV blocks and Steroids are helpful.

    2.Whipple disease

    3.Chagas disease.it can cause chagasic cardiomyopathy, achalasia and megacolon.
    IMAGE-The boy has Romana s sign. Zoom it for lid edema. The reduviid bug (the insect shown) bites (“kisses”) around lips.Hence lip lesion and famous eponym for the disease is “kiss of death”

    4.Diagnosis is Trichinosis. EMB will show microthrombi in coronary arterioles with eosinophilic infiltrate.

    5.Third week

    6.Nivolucumab and ipilimumab

    7.B19 Virus involve cardiac endothelial cell not myocyte.

    8.Giant cell myocarditis, cardiac sarcoidosis, Lymphocytic myocarditis.

    9. Giant cell myocarditis

    10.Sarcoidosis

    Ref Braunwald Heart disease Ch 79 11 th edition

    Liked by 1 person

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