Myocarditis vs. Pericarditis
On the test, if you have an infection question, it is Coxsackie virus.
MCC of myocarditis and pericarditis;
MCC viral meningitis = Coxsackie virus.
Cause of hand, foot and mouth dz? Coxsackie virus
Herpangina is due to Coxsackie’s virus.
Example: Pt with heart failure did an endomyocardial bx and it had lymphocytic infiltrate in
there, and it was due to Coxsackie’s myocarditis. To dx, need to do a bx of subendocardial
tissue, and will see lymphocytic infiltrate (as expected with ANY virus). Therefore, ie, pt in heart
failure, bx of myocardium has lymphocytes = Coxsackie’s virus myocarditis
Chest x-ray – see water bottle config – this pt as muffled heart sounds (cannot hear anything),
when the pt breaths in, neck veins distend (shouldn’t happen b/c when you breath in and
increase neg intrathoracic pressure, the neck veins should collapse on inspiration), radial pulse
is decreased on inspiration, when you take BP there is a drop of 10mmHg during inspiration.
Dx? Pericardial effusion
What the name of the triad? Beck’s triad. What is the name of the sign? Kussmaul’s sign. What
is the drop of 10 mm Hb on inspiration? Pulsus paradoxus. How does all this occur? B/c there
is an effusion of the pericardial sac, meaning that that heart cannot fill up (b/c there is fluid
around it) – leading to muffled heart sounds. So, when you breath in and blood is supposed to
get into the right side of your heart, it cannot expand. So, the neck veins distend instead of
collapse, which is called Kussmaul’s sign. What ever happens to right side of the heart affects
the left side of the heart b/c the left side receive blood from