Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of substernal chest pain, dyspnea on exertion, and palpitations. Symptoms preceded by a recent viral prodrome (fever, myalgia, URI symptoms). Denies orthopnea, PND, or syncope. No history of CAD or structural heart disease.
Clinical Examination Findings
Cardiovascular: Tachycardia noted, S1/S2 present, S3 gallop audible. No murmurs or rubs. JVD present at 45 degrees. Lungs: Bilateral bibasilar crackles. Extremities: 1+ pitting edema to the ankles. Vitals: Tachycardic, normotensive, O2 saturation stable on room air.
Treatment Protocol
Initiate guideline-directed medical therapy (GDMT) including ACE inhibitors/ARBs and beta-blockers. Diuretics for fluid overload. Strict activity restriction (no competitive sports for 3-6 months). Monitor serial ECGs, troponins, and echocardiogram. Consider cardiac MRI for definitive tissue characterization.