Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Myocarditis can be caused by a variety of infections and conditions such as viruses, sarcoidosis, and immune diseases (such as
systemic lupus, etc.), pregnancy, and others. The most common cause of myocarditis is infection of the heart muscle by a virus. The virus invades the heart muscle to cause local inflammation. After the initial infection subsides, the body's immune system continues to inflict inflammatory damage to the heart muscle. This immune response actually prolongs the myocarditis.
What are symptoms of myocarditis?
Myocarditis can be mild and cause virtually no noticeable symptoms. The most frequent symptom of myocarditis is pain in the chest. When myocarditis is more serious, it leads to weakening of the heart muscle. Myocarditis can then cause heart failure (with symptoms of
shortness of breath, fatigue, fluid accumulation in the lungs, etc.) as well as heart rhythm irregularities from inflammation and/or scarring of the electrical system of the heart.
How is myocarditis diagnosed?
Myocarditis is diagnosed by detecting signs of irritation of heart muscle. Blood tests for heart muscle enzymes (CPK levels) can be elevated. Electrical testing (EKG) can suggest irritation of heart muscle and demonstrate irregular beating of the heart. Nuclear heart scan testing can show irregular areas of heart muscle.
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, or even fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
An upper respiratory infection is a contagious infection of the structures of the upper respiratory tract, which includes the sinuses, nasal passages, pharynx, and larynx. Common causes of an upper respiratory infection include bacteria and viruses such as rhinoviruses, group A streptococci, influenza, respiratory syncytial, whooping cough, diphtheria, and Epstein-Barre. Examples of symptoms of upper respiratory infection include sneezing, sore throat, cough, fever, and nasal congestion. Treatment of upper respiratory infection are generally with OTC medication and home remedies.
Dengue fever is contracted from the bite of a striped Aedes aegypti mosquito. Symptoms of dengue include headache, fever, exhaustion, severe joint and muscle pain, rash, and swollen glands. Since dengue is caused by a virus, there is no specific medicine to treat it. Treatment instead focuses on relieving the symptoms.
Coxsackie viruses may be divided into two groups. Type A causes hand, foot, and mouth disease and conjunctivitis, while type B causes pleurodynia. Both types sometimes cause meningitis, myocarditis, and pericarditis. There is no specific treatment for this disease.
Sudden cardiac arrest is an unexpected, sudden death caused by sudden cardiac arrest (loss of heart function). Causes and risk factors of sudden cardiac arrest include (not inclusive): abnormal heart rhythms (arrhythmias), previous heart attack, coronary artery disease, smoking, high cholesterol, Wolff-Parkinson-White Syndrome, ventricular tachycardia or ventricular fibrillation after a heart attack, congenital heart defects, history of fainting, and heart failure, obesity, diabetes, and drug abuse. Treatment of sudden cardiac arrest is an emergency, and action must be taken immediately.
Trichinosis is a food-borne disease caused by ingesting parasites (roundworms) in undercooked pork or wild-game meat. Symptoms of trichinosis include diarrhea, nausea, muscle aches, itching, fever, chills, and joint pains. Trichinosis usually resolves without treatment, but more severe cases are treated with thiabendazole, albendazole, or mebendazole.
Diphtheria is an infectious disease caused by the Corynebacterium diphtheriae bacteria. The disease is transmitted via contact with airborne droplets or direct contact with skin lesions. Symptoms and signs include fever, sore throat, hoarseness, difficulty swallowing and breathing. Antibiotics and the diphtheria antitoxin are used in the treatment of diphtheria.
Relapsing polychondritis is an uncommon, chronic disorder of the cartilage that is characterized by recurrent episodes of inflammation of the cartilage of various tissues of the body. Tissues containing cartilage that can become inflamed include the ears, nose, joints, spine, and windpipe (trachea). Tissues that have a biochemical makeup similar to that of cartilage such as the eyes, heart, and blood vessels, can also be affected. Nonsteroidal antiinflammatory medications (NSAIDs) is used as treatment for mild cases of the disease. Steroid-related medications also are usually required.
Meningococcemia is a bloodstream infection caused by Neisseria meningitides. Meningococcemia symptoms include fever, headache, fatigue, and body aches. Meningococcemia is treated with intravenous antibiotics. There is an effective and safe vaccine to protect against most serogroups of meningococcus that cause meningococcemia.
A heart biopsy, also called myocardial biopsy or cardiac biopsy, is an invasive procedure to detect heart disease that involves using a bioptome (a small catheter with a grasping device on the end) to obtain a small piece of heart muscle tissue that is sent to a laboratory for analysis.
Why Do I Need a Myocardial Biopsy?
Your doctor uses myocardial biopsy to:
Evaluate or confirm the presence of rejection after heart transplant.
Diagnose myocarditis (inflammation of the heart muscle) or certain other cardiac disorders such as cardiomyopathy or cardiac amyloidosis.
How Should I Prepare for a Heart Biopsy?
To prepare yourself for a heart biopsy you should know these things:
The procedure takes place in the hospital. Usually, you will come to the hospital the day of the test and it is performed as an outpatient procedure. In ...
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