User:Jrstultz/sandbox

Complications
From the signs and symptoms section:

Other complications that need citations:
 * Sudden death (in young adults, myocarditis causes up to 20% of all cases of sudden death)


 * Dilated cardiomyopathy (inflammatory)
 * Chronic heart failure
 * Heart transplant
 * Arrhythmias
 * Heart block to varying degrees

-- Prognosis // Outcomes

Chronic Myocarditis

Info

Acute Myocarditis
 * https://www.sciencedirect.com/science/article/pii/S1050173820300797?casa_token=Bq2hflRxqx8AAAAA:1m0aHHXW4iMG-c_6vNn4Bl2bluya0IddbAjeelO8qIO4omOY9z0u2uOclo9c3KKV2_Vgo99Bq_8
 * https://pubmed.ncbi.nlm.nih.gov/32497572/
 * Outcomes vary greatly, with cardiac mortality and need for a heart transplant occurring solely in acute complicated myocarditis = LVEF < 50% on first echo +/ sustained ventricular arrhythmias +/ hemodynamic instability
 * Multiple studies demonstrated hemodynamic compromise as most significant contributor to prognosis, challenging long-accepted theory of fulminant myocarditis correlating with a paradoxically improved prognosis in comparison to acute non-fulminant myocarditis
 * Outcomes associated with hemodynamic instability on presentation = cardiac mortality (especially 30 day) and need for heart transplant
 * In largest study, rates of cardiogenic shock were 8.6% and in-hospital mortality // need for heart transplant were 2.7%
 * Another study distinguishing FM and AM showed cardiac death // need for transplant at 60 days was 28% vs. 1.8% and at 7 years was 47.7% vs. 10.4%

Fulminant Myocarditis

Info

Random
 * https://pubmed.ncbi.nlm.nih.gov/33441003/ PMID: 33441003
 * Late gadolinium enhancement on MRI is significantly associated w/ all-cause mortality, cardiac mortality, and major adverse cardiovascular events in patients with acute myocarditis
 * Included presence of any late gadolinium enhancement and specifically looked at anteroseptal late gad enhancement -- both significantly associated
 * https://pubmed.ncbi.nlm.nih.gov/32040731/ PMID: 32040731
 * Similarly, LGE on MRI is significantly a/w cardiac adverse events and cardiac mortality
 * Also, LVEF correlates with prognosis with a set point of 50%
 * https://radiopaedia.org/articles/late-gadolinium-enhancement-2?lang=gb
 * Definition of LGE and associated findings on pathology
 * https://www.sciencedirect.com/science/article/pii/S014067361160648X?casa_token=rCGOx-k6ZE4AAAAA:HO3UNzcnZrKRVD3EiC4RyfIwXyAbG8Pn_L_YX59Da_57WqnYgaVlbkhavqERFSNHIg_Fo817JmQ#box1
 * Chronic myocarditis seems to be a spectrum that can lead to // is related to inflammatory dilated cardiomyopathy
 * Prognosis can be related to cause, such as Chagas disease vs. HIV
 * https://www.nejm.org/doi/full/10.1056/nejmra0800028?casa_token=w0N9rlFgs3oAAAAA%3AbL7BeUgLaX9mNoD7rKQlASGq_2dc_Radvk-PablDerx_w5C8RvzUkdDt_snLrbG2Fb2kmAu7QCixgls_
 * Chronic myocarditis can result from lack of viral clearance in subclinical or clinical acute myocarditis
 * Chronic myocarditis leads to dilation of heart and related cardiomyopathy
 * https://link.springer.com/article/10.1007/s00380-021-01914-y
 * Chronic myocarditis
 * https://www.nature.com/articles/s41392-020-00360-y
 * Fulminant myocarditis