Miocardite aguda: 16 pontos que todo médico deve conhecer
Palavras-chave:
miocardite, miocardiopatia, inflamação, insuficiência cardíacaResumo
A miocardite aguda é uma miocardiopatia polimórfica adquirida e subdiagnosticada que ocorre por inflamação do músculo cardíaco. Acomete mais frequentemente pacientes jovens, causando aproximadamente 10% a 12% das mortes súbitas e ¾ das cardiomiopatias dilatadas. Os sintomas podem variar desde nenhum ou dor torácica leve até franca insuficiência cardíaca, podendo ocorrer apresentação dramática como miocardite fulminante caracterizada por choque cardiogênico, arritmias hemodinamicamente significativas (bloqueios cardíacos, taquicardia ventricular), insuficiência renal e disfunção de múltiplos órgãos que requerem suporte circulatório como assistência de membrana de oxigenação extracorpórea (ECMO). Visto que a apresentação pode ser inespecífica, estratégias na suspeita e investigação são necessárias para auxiliar generalistas, pediatras, cardiologistas e intensivistas a procederem ao diagnóstico. Biomarcadores, eletrocardiograma (ECG) e imagem multimodal podem ser a chave para a estratificação e proteção da maioria dos pacientes de um agravamento do curso da doença.
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