Guidelines for Diagnosis and Treatment of Myocarditis (JCS 2009)

Myocarditis is classified by its etiology, cell type (lymphocytic type, giant cell type, eosinophilic type, granulomatous type), and clinical type (fulminant type, acute type, chronic type) as shown in Table 1.3,4 3. Symptoms, Signs and Clinical Tests 1 Symptom Myocarditis is preceded by flu-like symptoms (chills, fever, headache, muscle aches, general malaise) or gastrointestinal symptoms such as decreased appetite, nausea, vomiting, and diarrhea.Cardiac manifestations of myocarditis appear a few hours to a few days after the initial signs and symptoms.5 Cardiac symptoms consist of (1) those of heart failure, (2) chest pain due to pericardial irritation, and (3) symptoms associated with heart block and arrhythmia.The possibility of myocarditis must be considered if a patient with such symptoms is febrile. SignThe clinical signs of myocarditis include fever, cardiac rhythm disturbance (tachycardia, bradycardia, and arrhythmia), hypotension, gallop rhythm, rales, jugular venous dilatation, and cardiac tamponade.