Complications

Complication
Timeframe
Likelihood
long term
medium

Often occurs in the setting of increased intra-atrial pressures and dilatation as a result of LV systolic and diastolic dysfunction and mitral valve regurgitation.

Acute atrial fibrillation

long term
low

Most commonly associated with Chagas disease myocarditis but can be seen in all etiologies of myocarditis.[8]​ Patients with symptomatic, recurrent ventricular tachyarrhythmias after myocarditis can be treated with antiarrhythmic drugs. An implantable cardiac defibrillator can be considered for more severe or sustained ventricular tachyarrhythmias. Catheter ablation can be an effective second-line option for patients with sustained monomorphic ventricular tachycardia.[21]

Sustained ventricular tachycardias

variable
medium

Presumably occurs due to progression of the original disease process. Developed in 21% of patients with acute myocarditis over a mean follow-up period of 3 years.[21]​ The patient should be treated with standard heart failure therapies and referred to a heart failure specialist.

variable
low

Usually caused by ventricular tachycardia or ventricular fibrillation associated with dilated cardiomyopathy. Up to 12% of sudden cardiac deaths in young people are estimated to be related to myocarditis.[21]

variable
low

Rarely occurs as a result of either acute presentation of fulminant heart failure or as the result of end-stage heart failure secondary to chronic dilated cardiomyopathy.

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