Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 10-43: Noninfectious Myocarditis + Key Features Download Section PDF Listen +++ ++ Causes include Autoimmune diseases Dermatomyositis Inflammatory bowel disease Rheumatoid arthritis Sjögren syndrome Systemic lupus erythematosus Granulomatosis with polyangiitis Giant cell myocarditis Drugs Aminophylline Amphetamine Anthracycline Catecholamines Chloramphenicol Cocaine Cyclophosphamide Doxorubicin 5-Fluorouracil Methysergide Phenytoin Trastuzumab Zidovudine Hypersensitivity reactions due to drugs Azithromycin Benzodiazepines Clozapine Cephalosporins Dapsone Dobutamine Lithium Diuretics Thiazide Methyldopa Mexiletine Streptomycin Sulfonamides Nonsteroidal anti-inflammatory drugs Tetanus toxoid Tetracycline Tricyclic antidepressants Hypersensitivity reactions due to venoms Bee, wasp Black widow spider Scorpion Snake Systemic diseases Eosinophilic granulomatosis with polyangiitis Collagen diseases Sarcoidosis Kawasaki disease Scleroderma Other Heat stroke Hypothermia Transplant rejection Radiation injury + Clinical Findings Download Section PDF Listen +++ ++ Clinical presentation varies widely + Diagnosis Download Section PDF Listen +++ ++ In patients receiving chemotherapy, it is important to look for subtle signs of cardiovascular compromise Serial echocardiography or cardiac MRI or both can provide concrete data regarding LV function Echocardiography/Doppler myocardial strain patterns may be the first abnormality observed and assessment of the T2 signal from cardiac MRI may provide early detection of cardiotoxicity Biomarkers such as B-type natriuretic peptide (BNP or NT-prBNP) may be valuable when serial measures are obtained Other biomarkers may appear early in the course of myocardial injury (especially troponin and myeloperoxidase) and may allow for early detection of cardiotoxicity before other signs become evident + Treatment Download Section PDF Listen +++ ++ High-dose corticosteroids and removal of the offending medication or underlying trigger is used to treat eosinophilic myocarditis Calcium channel blockers and nitrates may be effective in documented coronary spasm Usual therapy for heart failure or conduction system disease is warranted when symptoms occur