Internal Medicine

0521779407-01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:45

Acute Myeloblastic Leukemia Acute Myocarditides 41

complications and prognosis

Complications

■Infection: usually bacterial during induction therapy, bacterial or

fungal during relapse

■Bleeding: due to thrombocytopenia or DIC, CNS or GI may be severe

■Drug reactions: cytarabine, antibiotics, allopurinol

■Relapse

Prognosis

■Varies with age, cytogenetics, history of preceding preleukemic dis-

order

■Long-term survival about 25–35% with chemotherapy alone, some-

what higher with SCT

■Immunotherapy and oncogene-targeted drugs under development

Acute Myocarditides...................................

JOHN R. TEERLINK, MD

history & physical

History

■Presentation may be acute, subacute or chronic, but often rapid

onset with acute heart failure or cardiogenic shock

■Often previously asymptomatic or symptom onset days to weeks

after acute febrile illness or upper respiratory infection.

Signs & Symptoms

■See also acute and chronic heart failure chapters, and chapters per-

taining to specific etiology

■Chest pain, often pleuritic or non-specific

■See also acute and chronic heart failure chapters, and chapters per-

taining to specific etiology

tests

■Basic Tests

➣See acute and chronic heart failure chapters, and chapters per-

taining to specific etiology

■Specific Diagnostic Tests

➣Chest X-ray: cardiomegaly (size and shape can assist with

dx); pulmonary vascular redistribution, interstitial pulmonary